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Warning signs?

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Warning signs?

Postby Bob7777 » Thu Dec 27, 2018 7:20 am

Three weeks in to therapy, I feel worse than before I went in. Nightmares, insomnia, anxiety, rumination that I did not have right before.

The therapist has asked me to talk through my trauma, but it feels like it is re-traumatizing me. He has offered no guidance or preparation for me going though this. His few comments include "I don't know what to say" and that certain psychotherapeutic theory is "s***". I saw him concealing a yawn in the last session.

Some say that people make up excuses to avoid therapy because they're scared. Some say that some therapists do more harm than good.

Comments welcome.
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Re: Warning signs?

Postby TheGangsAllHere » Thu Dec 27, 2018 6:13 pm

Tell him exactly what you said here—that it feels re-traumatizing, his comments so far have been unhelpful and have not left you feeling trusting or confident in his ability, and he has appeared to be bored with what you’re saying. Mention your worsening symptoms (although that may have to do with your issues rather than with his competence and fit as a therapist for you).

See how he responds—if he seems to be honest, genuine, apologetic, and open to hearing your experience, then maybe give him another chance. Otherwise I’d consider finding someone who does have those characteristics.
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Re: Warning signs?

Postby Wally58 » Thu Dec 27, 2018 7:52 pm

When I began discussing my past and my triggers in therapy, it dredged up all kinds of feelings, doubts and trauma. My sleep suffered. The first half of the day was difficult from the intense dreams that I had. It was a tough time that gradually got better.
These 'warning signs' may instead be signs of working through past stuff and getting better.
Best of luck to you. :D
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Re: Warning signs?

Postby Bob7777 » Fri Dec 28, 2018 8:14 am

Thanks both of you, so much. Each of you have generously provided insightful and intelligent comments from your perspective and I am most grateful.

One of the main things that is bugging me is the structure of one session per week. It seems to be counterproductive in my case and I went in with that idea. So I am open to the possibility that I am going through some kind of elaborate confirmation bias; on the other hand, it's equally possible that as a trauma survivor I might understand my processing of trauma a little better than the therapist who hardly knows me and moreover is not a trauma specialist.

Knowing how my mind tends to deal with recall, at the start I did ask for double sessions and/or two sessions per week. But the therapist declined citing the necessary process but I note that he is not a dedicated trauma specialist. I also had the impression it was at least as much about his busy schedule. I acquiesced to his preference and now fear that in doing so I have again agreeably walked into the very trouble I saw coming (which itself is noteworthy in the context of self-help).

The reason why I wanted many sessions up front is that by personality type I am relatively extroverted and so don't have a problem with opening up and don't need a 'slow burn' to do so. Catharsis isn't on my wish list, I have done a lot of it already and possibly even too much.

I have experienced a lot of complex trauma so there is a lot of life story content to get through, all and any of which triggers various forms of post-traumatic reaction in me. I know this much because of experience and work on myself by myself over decades. I was sure that I wanted to talk the therapist through my past as quickly as possible in order to avert re-traumatization.

I could use the metaphor of surgery that we'd prefer to have done in a one-day session rather than in one-hour blocks that will take a couple of months to complete. Right now, I've gone in for three hours of surgery across three weeks and opened up the wound, and I'm walking around with it bleeding everywhere and it causing a lot of pain. I'm tempted to reach for a bandage (indeed after waking up from one vivid nightmare of recollected trauma I had half a bottle of red wine for breakfast, and I'm not a heavy drinker) and not go back into surgery, or go back and say everything needs to be stitched up unless we complete the surgery right away.

One solution I've thought of is writing up all the trauma in a Word document and emailing it to the therapist. That way it would be the kind of 'closed recall' that I wanted from the start. Then we could get onto my preferred topics of conversation, such as how to focus instead of dissociate, how to control intrusive thoughts and how deal with power relationships in the present in order to avert the pattern of abuse.

Perhaps there is a middle way combining the two very helpful comments from the kind strangers above. Thank you, my invisible friends.
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Re: Warning signs?

Postby Bob7777 » Fri Dec 28, 2018 9:15 am

Further to my last comment *mod edit* I ought to clarify why I am seeing a non-trauma specialist even though I have self-diagnosed as having complex trauma. It's because I'm an expat and live in a country where English-speaking therapists are are small segment, and that segment is even smaller if you want (i) an older, experienced therapist who (ii) is a man and (iii) is a mainstream psychologist rather than a psychoanalyst or spiritual type. It was a task just to get this much of a fit. So shopping around for a replacement isn't an immediate option.

Also, aside from the observations above (the concealed yawn and the two surprising comments) there's something I like about the guy, he has often seemed to be well-intentioned.

Secondly, I would like to clarify about my metaphor of painful surgery lasting weeks instead of a day. I would be very interested to know whether people here think the slow burn of retelling the traumatic events in weekly episodes is indeed beneficial to an open, extroverted client who has no inhibitions about retelling it all in one go, right at the start.

Because I am assuming this slower process is only helpful to the therapist's busy schedule while it is actually damaging me. So I would like to know whether there is something about it that might be helpful, that my assumptions might be wrong. I am open to this possibility.
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Re: Warning signs?

Postby TheGangsAllHere » Fri Dec 28, 2018 3:52 pm

Bob7777 wrote:I have experienced a lot of complex trauma so there is a lot of life story content to get through, all and any of which triggers various forms of post-traumatic reaction in me. I know this much because of experience and work on myself by myself over decades. I was sure that I wanted to talk the therapist through my past as quickly as possible in order to avert re-traumatization.

I could use the metaphor of surgery that we'd prefer to have done in a one-day session rather than in one-hour blocks that will take a couple of months to complete. Right now, I've gone in for three hours of surgery across three weeks and opened up the wound, and I'm walking around with it bleeding everywhere and it causing a lot of pain. I'm tempted to reach for a bandage (indeed after waking up from one vivid nightmare of recollected trauma I had half a bottle of red wine for breakfast, and I'm not a heavy drinker) and not go back into surgery, or go back and say everything needs to be stitched up unless we complete the surgery right away.


Bob7777 wrote:Secondly, I would like to clarify about my metaphor of painful surgery lasting weeks instead of a day. I would be very interested to know whether people here think the slow burn of retelling the traumatic events in weekly episodes is indeed beneficial to an open, extroverted client who has no inhibitions about retelling it all in one go, right at the start.

Because I am assuming this slower process is only helpful to the therapist's busy schedule while it is actually damaging me. So I would like to know whether there is something about it that might be helpful, that my assumptions might be wrong. I am open to this possibility.


Whoa, there! This is a LONG process, not a surgical procedure. Complex prolonged trauma is as much about attachment issues as it is about the "content" of what happened to you. Perhaps more so. You are re-traumatizing yourself with this approach, whether the "surgery" takes weeks or a day. It is NOT necessary to approach it this way.

The therapist does NOT need to know (yet) the details of what happened to you in your life in order to help you NOW. I know that it FEELS urgent and necessary, but you need to tell yourself (possibly literally--I don't know how dissociated you are), that all will be heard eventually, but that you need to wait and SLOW DOWN.

Bob7777 wrote:Then we could get onto my preferred topics of conversation, such as how to focus instead of dissociate, how to control intrusive thoughts and how deal with power relationships in the present in order to avert the pattern of abuse.


You can START with this, believe it or not. Every interaction with the therapist is illustrating your way of being in the world, interacting with others, and having relationships. The relationship with the T is the MOST important thing, especially at the beginning. Prolonged early abuse causes (and results from) attachment issues.

Please go back and look at my earlier comment about how to bring your feelings about the therapist and the process INTO the session and talk about them.

This is a "power relationship" in which you are already starting the pattern of abuse.

Also, "intrusive thoughts" are not to be controlled but to be observed, welcomed, and listened to with open curiosity, as much as you can tolerate--I recommend journaling. Just get everything down on paper and don't go back and edit (I'm talking about your current thoughts and feelings, NOT a compendium of your past experiences--yet).

Therapy for trauma that has been prolonged and severe enough to cause chronic dissociation has three phases and the first is safety, stability, and developing trust in the therapist. Phase 2 is trauma work and there are many returns to phase 1 as you go along.

You may want to consider a Skype or phone consult with someone in another country who IS an expert on cPTSD and/or dissociative disorders, to get an expert opinion on how to proceed.
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Re: Warning signs?

Postby Bob7777 » Fri Dec 28, 2018 5:17 pm

Thanks for reply. Yes, this makes sense. I guess you know that the use of capital letters can come across as shouty, and I assume this was not your intention. Your help is greatly appreciated.

To clarify, it's the therapist who has asked me to talk through the traumatic experiences, it was not my idea but I went along with it until now.

I understand that recovering from complex trauma is not surgery; I did not use the word literally, but metaphorically. I could just as well use a metaphor of building a house one day a week across a decade, or of completing a marathon at one meter per day, or of having a hair waxing being done in slow motion. It was strictly to describe the process of undertaking a the task of recounting the past in what feels like a counter-productively staggered pace that only exacerbates the suffering.

Without using a metaphor, the week-long gap between each episode is causing a very unpleasant reaction which I believe could be averted by either not recounting the traumatic experiences or by recounting them across a shorter period of time. I would have preferred the therapist to have clocked this risk already, but I'm willing to take responsibility for going along with it.

I may have used the jargon word 'dissociation' too quickly. I was using it merely to refer to concentration issues while watching films and reading books, and my mind wandering while in conversations with other people.

Other symptoms are all consistent with complex trauma and inter-generational war trauma (my father was a child when caught up in urban combat during WWII, then put with his mother in a Nazi camp where rape was commonplace, then maimed in an explosion).

My next step is going to be to tell the therapist I would like to stop that process of recounting the trauma, to explain that it feels like re-traumatization, and for us to address the present and future rather than the past.

Thank you again.

So that this thread can be of use to others in a similar situation, I am hereby sharing some online material that is pertinent:

https://www.psychologytoday.com/us/blog ... ma-is-wise

https://brickelandassociates.com/need-t ... therapist/

https://www.psychologytoday.com/us/blog ... tizing-you

https://psychcentral.com/blog/10-introd ... monly-ask/

https://drkathleenyoung.wordpress.com/2 ... a-therapy/
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Re: Warning signs?

Postby TheGangsAllHere » Fri Dec 28, 2018 11:20 pm

Bob7777 wrote:Thanks for reply. Yes, this makes sense. I guess you know that the use of capital letters can come across as shouty, and I assume this was not your intention. Your help is greatly appreciated.


Sorry--I was using caps rather than italics just for emphasis. I do feel strongly about all this, but definitely wasn't meaning to shout.

Bob7777 wrote:I understand that recovering from complex trauma is not surgery; I did not use the word literally, but metaphorically. I could just as well use a metaphor of building a house one day a week across a decade, or of completing a marathon at one meter per day, or of having a hair waxing being done in slow motion. It was strictly to describe the process of undertaking a the task of recounting the past in what feels like a counter-productively staggered pace that only exacerbates the suffering.

Without using a metaphor, the week-long gap between each episode is causing a very unpleasant reaction which I believe could be averted by either not recounting the traumatic experiences or by recounting them across a shorter period of time.


I don't think recounting them across a shorter of period of time is more useful or less damaging than having it be prolonged over weeks. It might feel like you would be getting it "over with," but the odds that the therapist would absorb and remember all the details you would want him to are slim to none, and it would probably still be a very painful experience that would need to be revisited each time you thought he "already knew" something that he didn't.

It was the "not recounting the traumatic experiences" approach that I was strongly recommending.

Bob7777 wrote:My next step is going to be to tell the therapist I would like to stop that process of recounting the trauma, to explain that it feels like re-traumatization, and for us to address the present and future rather than the past.

Thank you again.


I hope that he responds well to this--a good therapist wants to understand your experience, to "be on the same page" as you, and to be consistent, honest, predictable, and accepting. Examining the process and the relationship is where most of the healing occurs.

You're welcome. I would be interested to hear what happens, if you don't mind sharing.
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Re: Warning signs?

Postby Bob7777 » Wed Jan 23, 2019 7:45 am

Wally58 wrote:When I began discussing my past and my triggers in therapy, it dredged up all kinds of feelings, doubts and trauma. My sleep suffered. The first half of the day was difficult from the intense dreams that I had. It was a tough time that gradually got better.
These 'warning signs' may instead be signs of working through past stuff and getting better.
Best of luck to you. :D


Wally thank you. I'd be curious to know a bit more about whether this had been the first time you had discussed everything in depth. Because that's the crucial difference.

The rationale of my therapist is indeed that talking through the experiences is going to abate my post-traumatic responses, but many sessions in now I am not sure that this was the right decision.

This is because I have never in my life avoided talking about the experiences in the first place; on the contrary, I focus on them all the time and that preoccupation is the problem. I have done a huge amount of honest reflection and self-improvement over the years, partly with the help of reading and friends and some kind of good fortune that hitting rock bottom several times brought with it the strength of a rock.

But that focusing is often done involuntarily and habitually - and burdens my nearest and dearest with the subject matter to the point that it bothers them. Talking about it in treatment has stimulated or aroused this tendency. It's counter-productive.

I believe the therapist made a false assumption that I had avoided talking or thinking about the traumatic experiences, that I needed catharsis or even sympathy. For survivors who have got themselves out of hell to lead pretty functional and authentic lives with good personal relationships, this is plain wrong.

He has also been so shocked by some of my experience that he has said "What a story, what a life. I don't know what to say" and "I don't know what to do with all this." But he has also said that he thought I was vulnerable and in special need of an accepting and passive stance from him. That now looks a lot like an excuse for not knowing what to do.

In the last session, he actually left his notes from a previous session with another client in front of me, and left the room. Clearly innocent absent mindedness, but clearly unethical. When he came back I told him that I like him (to which his face lit up) and yet I wondered where all this was going. He has not once tried to establish some goals. I pushed this topic and invited him to discuss our goals. He had to ask me how many sessions we've had, and actually estimated wrong. At one point he broke in to embarrassed laughter and I had to ask him: "Why are you laughing so hard?" It turned out that he had felt uncomfortable about his last comment sounding like he was being a "bull-shitting therapist" (his exact words) and I reassured him that this had not crossed my mind. For a second it was as if our roles had reversed. I find this to be another warning sign.

The take away is a reminder that survivors of trauma who have helped themselves might be far more robust than some healthcare professionals might assume. Meanwhile therapists are fallible humans like the rest of us.

I do like him as a person, I think he has a good nature and tries to be sensitive. I even feel sympathy or even pathos that he appears to be out of his depth. But I remain unconvinced that this isn't a waste of time (with possibly a risk of actually causing some trouble).

A fair question to ask is whether this is all my narcissistic mirage that I have created to console myself, a delusion that I've got it all worked out, that my ass is smarter when in actual fact my head is up it. That's always a possibility, but right now I doubt it. We'll see how it goes.
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Re: Warning signs?

Postby Wally58 » Wed Jan 23, 2019 11:30 pm

I had been through detoxes and rehabs a few times and felt that I was running out of 2nd chances.
I had to put everything out on the table for discussion. While I was always honest with the therapists, I had to dig deep and start at the beginning the last time around.
If anyone can be born an alcoholic, I was. My reactions and defenses were just what an alcoholic would do. Once I had a taste of alcohol, I was off and running with it. Once I began drinking, I could not stop.
I lived this way for 15 years. The last time around really was my last chance at recovery. It saved my life. I got more than my money's worth! :D
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