Issues with CPT

[pelicantown]

I've been in "regular" psychotherapy (talk therapy, I suppose!) for 6+ years now and have strived to start sex therapy with a different specialist. I've had two sessions with her now and enjoy them, but the cognitive processing therapy that we've been doing just doesn't seem to resonate with me.

I feel like it's more so for people who have persistent thought patterns and "If X then Y type" thought processes, but I'm someone who doesn't really have any thoughts in that manner ( ). She gave me an exercise to do on "stuck points" but it took me eons to even try and think of an "If X then Y" statement or an action-consequence statement.

I'm someone who is very physiological where I simply feel emotions but don't have a thought behind them necessarily. Do I talk to her and revert back to talk therapy??? For the record, the "opposite end" of the spectrum, EMDR, also did not work for me when I tried it briefly (about 3-4 sessions). I simply started dissociating and it stopped becoming effective.

[Kizzie]

Just my thoughts PT, but I think we are (or need to be) in the driver's seat when it comes to therapy. If you feel like you want/need to speak up/look for another therapist then absolutely do so. There are so many different therapeutic approaches for CPTSD that we need to find what works for us.


   

[TheBigBlue]

This resonates very deeply with me. I've noticed something similar in myself: my cognitive adult part ("apparently normal part=ANP) can engage with CBT/CPT just fine (in fact likes it), but when I drop into a much younger emotional state (emotional part=EP), that same approach doesn't just miss me - it can actually feel harmful.

For most of my life, survival meant self-erasure and being alone with big feelings, with no one there to help me make sense of them. So when my EP finally has a voice, what she needs first isn't correction or reframing, but witnessing. Recently I had a strong emotional flashback around my narcissistic father and the golden-child dynamic with my sister. My inner child said, very simply, "I felt unlovable." When my therapist immediately tried to redirect that thought, I understood the intention cognitively - but emotionally it sent me into days of deep sadness and distress. It took me a while to realize why: the little me didn't feel allowed to tell her lived experience without being corrected.

So this week, I asked my therapist if we could try something different: giving the first part of the session to letting that younger part tell her story, with only listening, reflecting, attunement, meaning witnessing - and then using CPT later in the session if it felt appropriate. That collaboration made a huge difference. I left the session feeling calmer and more settled.

I'm not offering this as advice or suggesting this would be the right approach for you - just sharing what helped me, and to echo what Kizzie said: you're allowed to receive therapy that actually works for you. It's okay to name what you need, and if a therapist can adapt and grow with you, that's wonderful. If not, you still deserve care that fits how your system works.

(If that's ok)

[NarcKiddo]

Different approaches suit different people, and the same approach may be helpful at one point in time and not at another. I don't really have experience of formal approaches of therapy. I have been with one therapist for the last few years. We started with a CBT type approach because that was mandated by the platform we worked on but it quickly became clear that was not suitable for me. It was not actively damaging, but pointless, so we switched to face to face talk therapy and have been doing that ever since. I have tried various types of physical therapy - massage, acupuncture for example. My approach with anything like this is if it feels actively unpleasant from the get go I conclude at once it is not for me. If it feels great then I will continue until such time as it stops feeling great when I re-assess. If I'm not sure I will give it a few sessions to see if I settle into the approach. It can take a while to get familiar and relax enough to see benefits. If I stop a particular thing but didn't find it actively unpleasant then I may try again some time later to see if I am now in a position where it could be helpful.

I agree with the posters above that a collaborative approach to therapy is the most likely to arrive at what you need. So I hope the therapist is flexible and approachable.