January 26, 2010


Trauma Processing, Therapy & Counseling

I know a lot of us out here in the blogosphere have a "T;" a therapist we go to once a week, once a month, whenever. Some, like me, go through "therapy marathons," opting to go to T two or three times a week instead of going into the hospital for really intense processing work.

I've been in some form of therapy or another now, on a somewhat regular basis, for almost 20 years. Now, wait. Stay with me. Some of you who are rather new to therapy may be ready to shriek, "Eek! I'm outta here! I don't want to be in therapy that long! Who wants to be in therapy forever?!" I want to tell you that I'm one of the many unfortunate survivors who floundered around in the mental health system with an inadequate diagnosis for years. I didn't find out how severe my dissociative disorder was until just three years ago.

I didn't even know I had PTSD until after we moved to Colorado, less than a dozen years ago. My first official diagnosis was bipolar and I was put on Prozac. I have to give my first psychiatrist credit: He actually apologized to me a few years later and reversed my diagnosis. He told me that, while I had depressive episodes, my depression was situational, not cyclical. I wouldn't find out until just a year ago that what looks like "mania" on some occasions is actually the m.o. of one of my "let's-get-it-done-yesterday" parts.

Currently, I'm working with a woman who has over 20 years of experience working with dissociative patients. She's the "only game in town:" I'd have to drive over an hour each way to see another dissociative expert T in my state. I'm lucky to have her. Overall, I'm making tremendous progress with her. I've had no dissociative fugues or huge dissociative switching incidents that have been disruptive for over a year. I'm learning how to let some of my parts with even the toughest exteriors feel safe enough to have feelings and show their pain. I've given new "jobs" and crafted contracts with parts who I used to call "punishers." Now, we can talk about what they are protecting and what they are truly concerned about, instead of jumping to the dysfunctional reaction of self-harm. Just in the last few months, My T's told me she's even starting to see some--dare I hope it, much less say it?--integration. Hooray!

Before my current T, I was with an expert in traumatic stress and we made great inroads on trauma processing and getting my PTSD under control. I learned very useful grounding techniques and was able to vastly decrease my amount of nightmares and flashbacks. He also helped me learn how to greatly reduce my hyper vigilance and automatic startle response reactions. Heck, I can even go to a restaurant now and not be concerned about exactly where the exit (the escape route) is. I can sit at a table in a chair that is not backed up against the wall.

So, as you can see, I am grateful for my progress. I feel like I "shouldn't" complain. But, with all this great therapy "stuff," all the techniques the last two therapists I've had have pulled out of their well-educated and experienced bags of tricks, I feel like I'm missing something. What I miss, what I crave is counseling.

Does anybody out there know what I mean or feel the same way? Let me tell you what I'm talking about in my own experience. I know that some therapists do, indeed, give counseling because I had one--out of the many I've seen--who actually counseled me once. It was over a dozen years ago, back in Illinois, when I worked with her. I was a little put off, at first, by how "new-agey" she was, but I was immediately impressed by how compassionate and how spiritual (without being religious) she was, and by how much she cared. She also had great therapy techniques and ideas. But, what really moved me was her caring. Because she cared about me so much, she was very successfully able to counsel me on things that effected my day-to-day life. When I went in to see her for a session, we not only talked about my childhood abuse and my dysfunctional ways of coping; we could talk about anything.

I was so impressed with her and felt that her skills, empathy and advice were so needed, I drove three hours each way to see her!

Since that time--while I've had successful therapy and trauma processing sessions that could probably be sited in clinical training or published in some researcher's book--I've had very little counseling. I have a husband who is an only child and has lost both of his parents to cancer. Yet, I have no counselor to talk to about it (or really anything about my relationship with my spouse). I have a son who screamed at the top of his lungs with "colic" for seven months as an infant and now struggles with sensory integration, dyslexia and ADHD symptoms and has "twice-gifted" status at a school that does not meet his needs. Yet, I have nobody to counsel me on how to be the best parent I can be and how to squeeze out that last drop of patience and unconditional love I want to provide for him.

I understand that, when Mom is huddled in the closet in the fetal position or running away in dissociative fugues, PTSD and dissociative disorder therapy has to be the first priority. But, can't I ask for more? I'd like to have some counseling in the area of relationships.

In addition to me, my husband, son and sister each have their own individual therapists. My husband and son and I have gone to family counseling together. But, I have received next to nothing that I have found helpful or useful when I have asked either of my last two therapists to counsel me on my relationships with my husband, sister or son. Shouldn't the T I currently see, for up to four-and-a-half hours some weeks, be able to give me some useful advice on my current relationships? Aren't human relationships really what this life is about? I don't think the goal of all my hard work and intense therapy has been so I can be happier alone, living like a hermit in a bubble somewhere. I think it's been so that I can live my life in-relationship-with-beloved-others in a more functional, healthy, loving way.

Why do I feel sometimes--during the last eight years--that the only therapeutic success I've made is for some clinical study, or done in some cold, sterile research lab?
Why do I keep feeling like I'm coming up against some "all-or-nothing" type of strategy? Can't I experience a more balanced approach?

I'll probably tell you about my therapy appointment from last week that prompted this line of bloggy questioning. But, for now, I wanted to publish a more balanced post, instead of just a rant. In the meantime, feel free to share your own experience in comments. Tell me what you think.

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I think it's great that your therapist has seen some hints at "integration". I don't like that word much, but it sounds positive. And it seems that you do see this too.

Your therapist from Illinois sounds special. But everyone has their own ways of doing therapy. That way of doing therapy, for the therapist, puts her in a bit of a vulnerable position. Not everyone can or wants to do that.

It can be remarkably healing, though. But, it's not for everyone.

I can tell you that in my 20 years of healing, I have met both kinds of therapists... And even a mix of both kinds.

What I do now is to have a couple or few different clinicians be involved with me. This gives me some of each. I know not everyone (or even many) can have this option. For me, though, it's what I've found most helpful.

Thanks for a great post! For the Carnival??
I quite simply can't afford therapy and I found county mental health services entirely inadequate for dealing with someone like me who has a lot of issues but isn't someone in immediate crisis.
I'm bipolar and I can't take antidepressant medications at all. They make me completely manic. Although as I remember, Prozac mostly made me flat and increased suicide ideation. I find that doctors tend to want to thrust the trendy drug of the day at patients.
I'm definitely new to this whole therapy thing. I'm only 19 and things got pretty bad recently so I started therapy. I definitely feel like I'm being counseled by my T. I don't think it's enough but it's definitely been amazing. Thanks for sharing your insight. It helps me so much.
I'm new to this whole therapy thing. I'm only 19 and I'm just coming to terms with the fact that the abuse actually happened. For me it feels like my T is counseling and its been so amazing. Thanks for sharing. It always helps me so much to read.
I think that there are therapists that can do all of those types of therapy. I have read about them on blogs. But I haven't had one. I think it is normal and acceptable to want all of those elements to be a part of your therapy and healing.

Good and healing thoughts to you.

Paul: Thanks for sharing your own experience. I think I WILL submit this for the blog carnival. What a good idea! ;) I also have one for JIP I need to send in to you.

Lily Strange: Hey, so nice to "see" you. Thanks for stopping over and leaving a comment about your own experience. Yeah, I'm not on any anti-depressants right now myself. I stick to omega 3 fish oil. It does seem to help. I agree with what you've said about the trendy drugs. Aaaaccckkk! Don't even get me started!
Jade: Welcome and thanks for leaving your comments. When I was new to therapy, it really helped me to read as much as I could. Luckily, there is much more available on the Internet now. I wish you many blessings on your therapy/healing journey.

Kate: good and healing thoughts to you, too. Thanks for the validation and for sharing.
hi marj~ thank you for sharing your experiences. i believe you give hope and validation to tons of people who thought they were alone in the world.

i'm glad for you that you've had so many good experiences with therapists and have made such progress. for me, i never found an ideal therapist. though of course i'm so grateful for all the therapy i've had and feel like had i not had the support i did, i might not be where i am today.

i think it's such a good thing that you recognize an area where you feel you want more guidance and support. and i hope you are able to find what you are looking for. i agree that it seems you should be able to get help in all areas of your life from one therapist. but maybe therapists who are trained in trauma work are more like specialists. i don't know. have you discussed your needs with your current therapist?

i'm sorry i don't have much to offer here besides empathy. i'll be wishing you well and thinking of you~~
Well my friend I'm going to approach this from two different angles. As a person who has their own counselor and as a mental health clinician.

As a client I absolutely understand what you're talking about when you say you need "counseling" for me.. that means a deeper connection than my largest "issue"..if that makes sense.
As a counselor I have to ask..what kind of professional are you seeing (MFT, LCSW, Psychologist, Psychiatrist, hypnotherapist?) It just doesn't seem like they are approach is very narrow. Maybe you could tell them that you'd possibly like to start working from a more general veiw. Person in the environment approach (if you want to look it up ;-) lol)

I personally see a MFT. She is amazing. She approaches me from all different angles because I'm not very consistent from week to week with what is bothering me. And I have a good enough relationship with her to be able to say something isn't working or I need more of something. Be vocal girl. You're paying for the services, and if your therapist is any sort of good professional they will want your input for professional growth.

Sending you tons of positive energy my friend.
Katie & Jade: Thanks for sharing and thanks for those well-wishes, thoughts, empathy and positive energy. I have spoken to my therapist about this. Maybe I'll have to put up a post about my T session last week which will explain the particulars of where I stand with her on this issue. Maybe after the blog carnival on Friday. Thanks for your support, guys!
Hi there, sounds as if you're making great progress and I understand your concerns and need for a counsellor.Therapy is not counselling.There are good, experienced skilled ones about.
Good wishes.....
I'm glad you found someone who knows what she's doing. So important to be able to trust...I went through a few counelors...some who had no idea what to do...others who labeled and didn't help at all...one who just offered kindness..and finally one who knew how to help me walk out of the pain.
Wow there's another Jade out there! I had to look twice when I saw her post here. lol ;-) She's over a decade younger than myself... ahhh youth.. ;-)
Hi Marjorie--yes we totally get what you mean by the desire to not be quite so..."treated" for your illness than to work thru your life??? If we're not wrong? That you would like to feel that your illness is just a part of your life? Context. Of course you want your work to be in correct context. Honestly? We wonder if this may ne made abit tougher to achieve with the marathon thing, rather than say like the way we do it, twice a week. Sort of more...mundane in the week???? If that makes any sense? More a part of our regular routine??? However she goes wishing you well ----
Gee, I guess until now, I didn't realize just how lucky I am. I've not been shoved around the mental health system. My T covers all the bases - always has. We discuss anything and if I ask for advice, I get it by way of discussion until I can chose my direction. He is a great counselor, as well and a great therapist. I actually didn't know that some Ts don't counsel. I hope you find what you're looking for.
I have been doing therapy for almost two years now. My T's specialty is trauma work but she is also a counsellor. Although the majority of our work is trauma related we also talk about everyday stuff as it relates to me. To me it is somehow all tied together anyway. Thanks for this post. It certainly helps me out.
Von: thanks for stopping by with your comment. I agree: In my experience, I have not found therapy to be the same as counseling. Thanks for those good wishes. To you, as well.

Sarah: Finally one who knew how to help you walk out of the pain, huh? That is so well-said and just marvelous! I'm so glad!

Jade: Yeah, I know! When that comment came into my inbox without a picture I was thinking, "Silly, Jade! You're not 19!" No, it's another Jade! ;)

Anon: It's taken me a while to respond here. First of all, I get a little "lurky" feeling that makes me uncomfortable when people comment anonymously. Second, most people who really know me understand that I loathe the name "Marjorie" and nobody who supports me ever calls me that (at my request). But to answer your question, I guess: I rarely go to my T more than twice a week. When I have gone more than that, it's because my regular routine had already fallen apart.

Ivory: I think you ARE really lucky. And I'm so glad for you--you deserve that. I hope I find what I'm looking for, too; I'm pretty frustrated right now. Thanks!
lostinamaze: Ooops! Almost lost ya there--didn't want to miss responding to you. Thanks so much for stopping by and sharing your experience. I'm so glad you have a therapist who counsels--they are a special breed. And I'm glad this post is helpful for you.
I've never commented here before, but I've been reading your blog for a long time. I don't have a blog, but I hope it's still okay if I jump in here. I normally wouldn't comment, but I was shaking so bad when I got done reading your entry that I had to get up and walk for awhile. Your words didn't upset me...it's the topic. I know I need therapy but everytime I try it's just another big mess. I have been through about 20 therapists since I had my breakdown 3 years ago. They have all been disasters and have left me (in the words of both my GP and neurologist) with "PTSD on top of PTSD." One example is the therapist who decided to "pink slip" me because I "looked tired". She assured both my husband and me that she was sending me to a "really nice place" for a "couple of days of rest." I was then hauled off in HANDCUFFS in front of a waiting room full of people. The "really nice place" was the state mental hospital (we have incredible insurance coverage and I could have gone anywhere). Through "an error" I was hospitalized on the floor for "moderate to severe criminals." It was one of the most frightening experiences of my life. In addition to the flashbacks and nightmares I have from my abusive childhood, I also now have them from that hospital experience. And that was just one of many bad therapy experiences! One therapist even came on to my husband right in front of me!

Almost all of the therapists have started out telling me that my problems are probably too severe for anyone to help me. Nothing like discouraging a hurting person who has come to you for help!
I've finally accepted that the quality of my life will never improve. I've done what I can on my own through books and personal research. At this point my trust has been so shattered that I don't know if a good relationship could be established with a therapist anyway. It's extremely defeating to imagine what my future will look like if today I am paralyzed by frightening flashbacks & nightmares and suffocating under chronic pain.

I think that blogs like your yours and several of the others that I follow are a type of therapy for me. You all have excellent insights and observations. The things you share often apply to what is happening in my life or in my head. I've learned a lot from all of you. Thank you for being willing to share your stories.
I have never gone to a therapist, but I did do some counseling with my pastor a few years ago (he was my pastor, but also a licensed counselor) a couple of years before that I had met with a counselor for a while (but she wasn't really a good fit for me and I never got to the point where I trusted her enough to really work on any major issues with her)

A lot of survivors have told me over the years that they wished their Ts would provide counseling also. I think that there is a reason why some people identify themselves as counselors....because that is where their heart truly is.

I hope that if your T isn't willing to embrace counseling (that is what I am guessing at this point) that you will be able to find someone who will.
I like being a hermit, but I don't have any children, only grown others to deal with daily.

For me/us, life is different than most other survivors I've met. Our integration is at the point where no one needs to act out. How long this will last I'm not sure, but for now, in a good place.

Hope you find some counseling soon.
cookie: Thank YOU for commenting, sharing your experience and letting me know my blog has been helpful to you. It sounds like you have been subjected to a lot of cruelty and quackery. I'm so sorry. I hope that your own path leads to healing for you.

Tracie: Thanks. And thanks for sharing. Nice to "see" you!

Brian: So nice to "see" you, too! I'm glad you're at the point where no one needs to act out. I've just reached that status myself within the last six months (part of the success from the therapy marathon, thank you very much). I sure hope it stays that way for both of us. (all of us)
I too have been in therapy on and off for over 20 years and I can relate to what you are sharing. My first therapist didn’t have the training, our second therapist does and we talk about everything, past and present. We have to travel far to see her in person, so we spend a week a year doing intensive therapy in her office and counseling on the phone when we choose to set up an appointment during the year, we haven’t done Skpe yet but others do have sessions that way. I would make your needs clear to your current therapist and see what they say…
I too never thought about the difference between therapy and counseling. I am so grateful for the latter. To have someone who cares about you, your feelings and your hopes/dreams is unexplainable. I will pray that you can find that person for you. You want it.. go find it.
Thinking and listening here with you dear one. ((((Marj))))
Exhale: Thanks for stopping by with your comment. I used to have phone sessions in between with the woman in Ill. I drove six hours to see. The Skype thing is an interesting idea. I've done Skype with friends who live far away.

Lily: I'm so glad you have a trusted counselor. I'm happy for you.

JBR: Thanks for always providing those wonderful hugs. Backatcha, friend!
I would like a "life coach" s person separate than the trauma work that has some understanding about DID and such.

I would have liked a "life coach" for doing the trauma work.

I know I will be my own "life coach" It is just so hard when I am doing the work of trauma.
Michael: Thanks for visiting & leaving your comment. Hmmm...I've never thought about it this way before, but I think I am also my own life coach. And you're right: It is hard to do while trauma processing.
Marj, I have had three counselors in the past. One was group counseling which was great because I met other women like me who had survived incest and were struggling with life in general as I was at the time. That lasted for a year and a half. The second was individual counseling with a lady who was also my friend and mentor who also lead an incest survivors' group that I belonged to. When she was killed, I tried one on one counseling with a counselor who wanted me to basically start at the beginning with my incest. I felt that I knew more than she did about incest so I didn't go back after 3 sessions. It just wasn't working out.

I didn't realize that there was a difference between counseling and therapy until just recently.

Cookie4697, I feel angry and sad and even cried from reading about your experiences. None of us deserves to be treated like you have been treated by therapists. Revictimizing you should be a crime.
Patricia: Sounds like you've had your share of ups and downs with counseling as well. I'm glad you had a good experience with the group and your mentor for a while. I, too, was very touched by Cookie's comment and agree with what you've said. Thanks, as always, for your support and involvement.
Marj, congratulations on your progress and hard work. Reading all you've done to get where you are, I am impressed with your persistance and determination.

When you started talking about the therapist you saw in Illinois, I began to wonder if it is the same woman I am seeing now! She has been unbelievably good dealing with trauma and childhood issues, but she does counsel me (daily).

The first therapist I had was ALL counsel. All he did was tell me what I should be doing from day to day. There was no realy therapy that I could see. It took me a while to figure that out since I had nothing to compare it to.

It hadn't occurred to me that some therapists would be the opposite of that - only giving help with past issues and not with the issues of today.

I spent my entire sesison yesterday talking about marital issues. We have talked about problems with my kids, with my current relationship with my sister, with issues that have come up with friends...
Although we do focus on healing the past most appts., I get a lot of counseling from her in emails, as I said, daily.

I am so lucky. I knew it, but now I know it better.

thanks for your post.

I wonder if there isn't a way you could get both...
If your therapist is not a "counselor" by nature, maybe you could find a second resource to use for your current issues. A lot of people go to therapy privately and also go to couples counseling, for instance. Why couldn't you get the therapy appts you need, but also set up some appts with a counselor who could help with your day to day life?

I know insurance and cost are the likely obstacles... I hope you find what you are looking for, need, and deserve to have.
Thanks for saying that, Shen. I'm working on something as we speak. I hope I can get just the combination I'm looking for. I'm so glad you have someone to work with...and even e-mails you, Wow! I'm impressed. My T kept promising to come look at my dot com site and my blog but she never did. I don't bring it up anymore. I think I'd drop over dead if she e-mailed me! LOL!
The difference between therapists and counsellors is considerable
Cookie..PTSD and chronic pain can all be dealt with if you find the right person.Hope you are able to some time.
Von: I agree. At this point, I think I'm going to end up with two people. But, I'm okay with that as long as I get what I need.
I can relate to what your saying. I- don't think I do as well with therapists who *can't* help me with- my life in general, because- it's not *just* about trauma stuff, separated from the rest of it, it's about it all together. Trauma affects my relationships- my relationships affect my trauma responses etc.

I do see- even more clearly, reading this, why I am still holding onto contact w/my old therapist from up north, who I haven't been seeing regularly in person in a year, though we've been doing phone sessions, and sometimes I travel up there to do intensive work w/her. Because she's- special like that. I can ask her about- anything, and get some kind of feedback. Thank you for making me realize that. Also, on an unrelated note- when does the info on the next Carnival come out? I am starting a new actual blog (I've been meaning too, more then just my livejournal) and am interested in writing something for it.
strangelings: Thank you for reading and leaving a comment. I think your T "up north" really does sound special and I would definitely hang on to her, if even just for phone sessions. I'm glad you have someone like that.

As far as the carnival goes, thanks for your interest! I think I have a host for March, but not an edition date yet. But, you can always submit a post at any time and it will be saved for the next edition. If you go to the widget there on the sidebar, near the bottom in red it says "submit an article." Just click on that and voila! You're at the submission form.
To the commenter who called herself "Bridgette:"

Thank you for your kind words, but I did not include your comment with the link because I consider that spam. I am committed to keeping this a safe space for bloggers to share.

If you want me to follow you over at Twitter, I'd be happy to do so. That space is much more promotional and some advertising is okay with me there. This blog, however, is not the appropriate place for that. Thank you.
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