Monday, June 15, 2009

Treating PTSD Symptoms: Being Present in the Search for Therapy

When we enter into the therapeutic relationship, how focused are we? If you’re anything like me, not very. I was a mess. Such a mess (and so against being in therapy) that I didn’t actually choose, seek out, or decide upon my therapist. I hit rock bottom; splatted against a wall of depression and powerlessness, and then let someone else push the pieces together and into my therapist’s office. Sometimes, that’s just the way it has to be done. Sometimes this is the only way for us to make the decision to seek help — by not making a decision at all.

This isn’t, of course, the most self-empowering way to go about healing. No matter how difficult it is, we need to force ourselves to be present, just for a few minutes each day, to make determinations and decisions about how to help ourselves. For a few minutes we need to use all our energy to push the symptoms aside and ask the right questions. For example, Am I in the right place?

At first glance, my therapist, Henry, seemed perfect. He was kind, soft-spoken, intelligent, compassionate, the head of a psychopathic institute. I felt comfortable with him. I could speak easily and freely. He knew all about different therapy modalities, including CBT, EMDR, TAT, EFT, and TFT. We used them all. And we made progress. So, what was wrong?

Henry didn’t know anything about PTSD.

OK, to be fair, even I didn’t know I had PTSD at the time I began therapy. All we knew collectively was that I was one emotionally unstable girl with a slew of mysterious, undiagnosable and debilitating physical symptoms. But right there is the reason why we need to make sure we’re in the right place. The right therapist would have immediately been able to put the pieces of the puzzle together. If you have trauma in your past make sure you have a trauma trained therapist in your present. PTSD diagnosis or not, trauma training will be useful!

I spent 8 years on and off with Henry. I made great strides. I went from being unemployable because of my PTSD symptoms to holding a job, going through a post-graduate degree program, and falling in love (at the age of 33) for the first time. Good progress for someone who began therapy thoroughly depleted in both emotional and physical realms.

The problem was that even as I got better, I wasn’t getting better. My PTSD symptoms were still incredibly prevalent and my physical state continued to evolve and decline. While I found the strength to push through and refused to be bedridden again, what was happening in my body was frightening and extreme. By the time I moved from New York City to Florida I was on the verge of quitting yet another job because I just could not keep pushing my body to do so much when organs weren’t properly functioning.

The question is, why didn’t Henry make the PTSD-symptoms connection? Why didn’t he recognize there was a name - and so a protocol - for treating what ailed me? Why, indeed.

The simple answer: he wasn’t trained to. Henry specialized in spirituality and psychotherapy — a great combo when I started, not so great for healing the underlying cause of all my problems.
After 8 years and a big relocation and the gnawing feeling that something was still very wrong with me and so it required research, I led myself to my PTSD diagnosis, all alone.

My journey to a new therapist and PTSD began with my decision to research my trauma. For so many years I’d been avoiding learning about the details of my illness. Toxic Epidermal Necrolysis Syndrome (TENS) is very rare. I’d never met anyone else who’d suffered from it or had even heard of it. I decided to educate myself. I decided to speak to and connect with other survivors.

As I read everything I could about TENS an interesting thing happened: the words ‘trauma’ and ‘traumatized’ popped up a lot in the literature. Naturally, I began reading about trauma. In the trauma literature, the words ‘posttraumatic stress disorder’ frequently appeared. I looked up the definition. I took the self-administered quiz. I was shocked to find I had all the symptoms. Even more shocked that Henry had never mentioned PTSD. In our next session I asked what he knew about PTSD. He confessed he didn’t.

I decided I needed another opinion; I decided to find a trauma therapist. This decision is what led me to Holly, who was able to explain how dissociation worked and why I was using it so much just to get through each day. She was able to set me straight about trauma and how we get so lost in the vortex. She was able to support my own efforts and let me know the path I’d been defining for myself - of education, integration and proaction - was a good one.

I didn’t stay with Holly for very long. I’d already been through all the therapeutic modalities and was frustrated with the process. I didn’t want to do it again, even if it was going to be more properly directed this time around. I abandoned therapy and struck out on my own on a quest to do two things: integrate my traumatic memories and construct a post-trauma identity.

My conversations with Holly, however, gave me an invaluable gift: as a trained trauma professional she helped me build a framework and perspective for what I was experiencing now instead of only working with what happened then.

Sometimes, just a little perspective adjustment makes all the difference.


Time to take stock of the help you’re receiving. Is your therapist trained to help you? We can love our therapists, but if they don’t have the training to take us to the end of the PTSD road - or if we don’t connect with them in a way that facilitates progress - then we can’t remain with them. Separating can be difficult and tumultuous, but we owe it to ourselves to have the proper care.

In future posts we’ll cover how to choose the right therapist. Today, just consider your relationship with your therapist. Do you feel you’re making progress? Become aware of your attitude and interaction. Are you frustrated, stagnant or moving forward? Do you feel safe, in good hands, directed or lost? How do you feel about your therapeutic experience?

Our attitude is everything. If we don’t have the right one in and about therapy there’s a fundamental problem in the foundation of our healing.

Have you switched therapists? How did you realize a change was necessary?

(Photo: jswolfsberg)


Anonymous said...

I didn't choose my initial therapist - my chiropractor (who I'd confided in after a good 2-3 years of seeing him monthly and telling him nothing!) helped me with a referral to someone who was a trauma specialist.

She was very useful for a while. Certainly, we kicked a lot of goals together. But then we got to a point where she decided that talk therapy wasn't helping me any further, and I agreed. So she reccomended me to someone who was trained in EMDR.

Going to see this lady was an absolute breakthrough for me. But then, most of my PTSD symptoms were resolved (very quickly) and she felt it was up to me to decide what I needed to do next - come and see her some more or go back to my other therapist.

However, this coincided with me losing my job, and as such I haven't seen either therapist for the last few months.

I do know I need a little more help to deal with my general anxiety and the depression which seems to come and go. But right now I can't afford it.

When I can, in a month or so again, I'll have to decide what to do. I'm not sure actually. And one of my friends thinks perhaps I need to try someone new, who specialises in dealing with depression, now much of the trauma is behind me.

I'm very undecided though!

Michele Rosenthal said...

@svasti – Ha! Isn’t that the way healing goes? Not in a straight line, not all with one person, and never finished when we think it is. Your flexible approach to healing is inspiring. I think it’s so important that we know when to stay or go depending on what we need and what various professionals can offer us.

Lucky you that EMDR brought you so much relief. I think we all know what we need if we open our minds to hearing that internal voice. I’m confident you’ll make the right choice when the time comes!

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