Therapy Break? Feeling steady

[Blue_Jays]

I feel like I have turned a corner in how I feel about my family and the trauma side of things. I have a lot of distance between me and them, in every way, which is really helping. I got a new job, a good job, working locally, and that has made where I live feel more like home. I have been meeting lots of different people, and navigating new challenges. I have noticed that things that would usually trigger me and send me into an emotional flash back are not as big anymore.

My medication seems to be working, even though my anxiety and depression are still there they don't ruin my day.

My doctor wants me to slow down how often I see my therapist.. he said three years is enough time and maybe a check in when necessary is the next step. I was really thrown off by this. My therapist is an important part of my support system, and I feel like there is always more I can work on. I also seriously love having someone who knows the whole story, and sees me fully. However, after thinking about it, I see this more as a sign that I am actually doing alright. When I started therapy I was a mess, and my mom was ruining my mental health, I was in waves of agoraphobia and in a really toxic workplace. So with that in mind, I am actually really happy about how far I have come.

So that felt like a win.

I don't think my doctor understands PTSD well, or CPTSD. But he is willing to listen when I describe why life can be a serious challenge for me sometimes. So I can respect his thoughts on this.

Wondering what happened when others stopped going to therapy after going consistently for a few years? How did you come to that decision? How did you handle not having regular check-in's with your therapist?

[NarcKiddo]

I've been seeing my T for a good two years now. Maybe three. Can't remember. Like you I have been handling things much better and my therapist suggested a little while ago that we might reduce frequency of sessions. I had myself been privately wondering if it would be the right time to do this so I was pleased and proud when she made the suggestion for me to consider. We were talking about maybe going down to once every two weeks rather than every week. I had a challenging occasion coming up so said I would get that out of the way and then consider seriously.

Challenging occasion went fine, but my whole system has rebelled against the suggestion of reducing therapy. I've been grappling with all manner of things and it is quite clear that now is not really the time to reduce frequency for me. However what has happened is that we are working much deeper than we had been before. In fact it may soon be wise to try sessions slightly more spaced out just because of how long it is taking me to regulate after each one. We'll see.

I think, with respect to your doctor, that only you and your therapist are the people who can truly judge what should be done about the frequency of your sessions. Have you discussed it with your T?

I think you should be very proud of yourself for how far you have come and I think it should feel like a win that this suggestion has not been made. It may indeed be the right time for you to scale back, but it is very understandable that you might feel thrown by this suggestion. If now is not the right time to scale back then don't. It's not a failure if you don't scale back. And I am sure there are other options. I don't know how often you see your T now,  but a regular weekly slot to a check in when necessary does seem like a very big step. If your T can accommodate sessions less frequently, like every 2 weeks or once a month for a while that may feel more comfortable initially.

[Blueberry]

I think, with respect to your doctor, that only you and your therapist are the people who can truly judge what should be done about the frequency of your sessions.

 

I've been in therapy for years, and I make progress, but I've come to realise that so far I can't 'manage' on my own, I still get so dysregulated in the day-to-day and there's so much unprocessed trauma. I have had a year or two w/o therapy, but so far I've always gone back eventually. Some of it privately paid, like art therapy or intensive group healing retreats, but "you shouldn't need therapy anymore" / "you should be healed by now" / "you shouldn't need therapy more than once a month" said by some doctor    

That's my take on it.

[Kizzie]

I have to agree with NK and BB, IMO it's up to you and your T. Your GP may not know about the long term impact of CPTSD and that there are often things that cause our symptoms to surge when we're under stress. In any case it's what you feel you need and want that's really important.

Lovely to hear you''re doing so well for the most part! 

[Blue_Jays]

Thanks everyone.

I will talk to my therapist about it. If I do stop going, I know I will be back, I foresee some future challenges that I won't be able to handle without support (potentially years in the future).

I totally relate to not being able to manage on my own. I had to explain to my doctor that I needed the additional support when I was triggered or dysregulated, as I spiral pretty intensely. It was weird having to explain myself, ended up having to explain the reason why I think I will be in therapy forever (on and off). My doctor is very traditional, so they have rigid ideas of how things are supposed to go.

Appreciate hearing from others. 

[Papa Coco]

Hi Blue Jays,

I am 65 years old. I began therapy at age 20 after a two suicide attempts. That was 1980. Therapy back then was one step above leeches and electric shock. I saw my first therapist for 10 sessions when he told me we had completed it and I was cured. Two years later, another suicide attempt and I was in the office of a new therapist. I can repeat this story 6 times before I finally found the therapist I have now. I began seeing him in 2005 and have never stopped seeing him.

My first 6 therapists were not much more than just CBT's. Cognitive Behavior Therapists, which is not a style of therapy that understands lifelong trauma. I called them dog trainers. My 6th therapist openly called himself a "behavior modification therapist", meaning he could cure my broken heart by teaching me behavioral tricks. "Scream into a pillow and you'll be cured." "Snap a rubber band on your wrist whenever you think of suicide and you'll be cured." I didn't know any better, and the word "trauma" had never been uttered by any doctor or therapist ever. I had to assume I was just stupid and that's why I hated myself so bad.

I'm a people pleaser because I have CPTSD. Many of us trauma survivors are people pleasers. It's how we try to feel safe by being liked which is better than being bullied or damaged by not pleasing others. As a people pleaser, I would always do whatever my therapist wanted me to do, and when a therapist said I was cured, which 6 of them did every few years, I would honestly believe they were the smart ones and if they said I was cured, then I thanked them for curing me and left. I'm sure most of them still think I'm cured because I never called them back two years later to tell them I was worse than when they saw me.

My final observation was that CBTs had a bag of tricks they were taught to use and once they'd used them I'd feel better...temporarily. The duration of being cured tended to last for two years each time. Two years after being cured, 6 times, I'd end up worse than the time before because now I had proof that I was incurable. The more often therapy didn't cure me the worse I felt about myself and my incurable nature.

My 7th therapist is the first person alive to use the word "trauma". I couldn't figure out how I'd been traumatized, since I had never been to war nor in a plane crash. so how could I be traumatized? The term "Complex" PTSD hadn't been invented yet, so I had to figure out how a narcissistic family upbringing, and an abusive religion, and a few instances of CSA by trusted clergy when I was 7, could do to me what being shot at in a war did to people with far more catastrophic lives than mine. Doctors back then couldn't figure it out either. I'm sure more than 50% of all doctors world-wide still don't know that catastrophic trauma is different than choosing to be depressed because I don't snap a rubber band on my wrist whenever I feel mortal terror.

The moral of my story is that ONLY trauma-informed therapy works. And VERY few doctors understand that. Also, VERY few therapists understand that.  And my ability to feel cured comes and goes.

This week, after 45 years of therapy, 20 of those with the right therapist, I still am floored from time to time when I realize the powerful grip trauma still has on me. I STILL struggle to believe that my childhood was as damaging as it was. I STILL struggle to believe that I'm as traumatized as I am.

I have a long history of having a lot of fun. I have been a singer, a comedian, a sexual assault victim's advocate working as a volunteer for police and hospitals. I've been married for 42 years to the same amazing woman. I have raised children and grandchildren...by all appearances I have had a great life. And yet, I keep trying to kill myself. Doctors see my humor and my ability to converse and laugh and enjoy their company and they assume I'm having a great life. But if I'm having such a great life then why am I constantly trying to kill myself?

Because, it's been my experience, that my trauma is relentless. Yesterday as I was talking to some friends about how difficult it is for me to accept the severity of the damage that was done during childhood when my brain was still malleable, I realized...for the first time ever...that every suicide attempt in my history came as I was feeling abandoned by family, friends, and peers. Whenever I don't feel abandoned, I am a comedian and a singer and a community volunteer. But as soon as someone betrays me, or leaves me, or if for any reason I suddenly feel alone...bam!  Trauma comes back with a vengeance, and I realize my cure was temporary.

I truly am better now than ever before, but I've gained about 5 years of growth in 45 years. It's taken me 45 years to feel like I'm just 5 years better. I'm a slow learner, but i'm a learner. My therapist is 13 years older than me. He's 78. He says he'll never retire because he loves his patients and loves his work, so why would he retire from it? (NOTE: the CBT I had before him, CBT#6, used to stop me at 50 minutes and if I didn't stop talking, he'd put up a blocking hand and say, "I work for money. Your time is up for today". Big difference: One therapist loves his money, and the other loves his patients. Guess which one is making progress with me). I So my plan is to keep seeing him until death do us part because I've proven to myself that being cured is not in the cards, but being made better is. Progress, not perfection. As long as I'm making progress, I continue to see therapists.

I was glad to read in your original note that you are open to returning to therapy in the future. To me, that's a wise sentiment. If you are done with this therapist, then that's good, as long as you remain ready to begin therapy again if you need it. I did it many times. It gave me the chance to try out 6 losers before I found a winner. Thank goodness I always remained open to start therapy again if/when I might need it.

For me, now the things that have finally moved me from the repeating cycle of starting and stopping therapy, are: IFS therapy, EMDR, Ketamine Infusions, and one single event with MDMA. These things, along with the books I've started reading are making the most progress of my entire life. I will continue to see my therapist until one of us dies of old age. And I'll continue reading these amazing books that are adding a spiritual component to the physical issues. The authors that have been giving me this progress are: The Seat of the Soul by Dr. Gary Zukav, (With forwards from Oprah and Maya Angelou), Letting Go; The Pathway of Surrender, by Dr. David R. Hawkins, In an Unspoken Voice by Dr. Peter Levine, The Others Within Us, by Dr, Robert Falconer and Attuned by Dr. Thomas Hubl. All of these are therapists with no less than 40 years of experience giving trauma informed therapy. They understand trauma, how trauma rewired the brain, and how to move forward on the journey of progressive healing that we are all on. I may never be "cured" but I'll be a little closer to it every day as long as I keep following the path of healing.

I'm finally getting better, and yet I still have EF triggers, and I still have a need for a therapist. My therapist is a DBT. Dialectical Behavioral Therapist. Whereas CBT tries to stop you from dissociating, a DBT respects the dissociation and helps us manage it rather than try to push it away. Turns out, accepting myself and my quirks works better than trying to stop using the tools that have kept me alive for 65 years.

I'm rambling. Barely staying on topic. I'll stop here.

I'm glad to hear you are feeling better, and I'm also glad to read that you are wise and will continue to keep future therapy as an option any time it's needed.

[Kizzie]

I totally relate to not being able to manage on my own. I had to explain to my doctor that I needed the additional support when I was triggered or dysregulated, as I spiral pretty intensely. It was weird having to explain myself, ended up having to explain the reason why I think I will be in therapy forever (on and off). My doctor is very traditional, so they have rigid ideas of how things are supposed to go.

Appreciate hearing from others.

One thing that did pop into my mind as I re-read this thread is that physician's often DON'T know much if anything about CPTSD (which is why we just finished a book about complex relational trauma and CPTSD here, and I led a project to develop a guide for healthcare professionals). So yours may not realize that CPTSD does not go away entirely but we learn to manage it. That said, there are going to be events/situations in our lives that bring it up to the surface again and we will need support.  I think you're wise to know that about yourself and your CPTSD. 

By the way, the guide for healthcare professionals is available on the site at https://www.outofthestorm.website/healthcare-project if you want to have a look at it. There is a pdf download you could give to your doc so they understand better what you are dealing with.