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Therapy Options

My cc has been round today and after meeting the head of psychology, two options have been suggested:

Option 1: one to one art psychotherapy for approx. 6 months and then straight in to a democratic therapeutic community (DTC) with a commitment period of 1day a week for 1 year and then less often for another year.

Option 2: DBT (dialectical behaviour therapy) which is 1 one to one session per week, 1 group session of 2 1/2 hours and telephone support.

To be honest, I didn’t like the fact I was being offered therapy for what seemed like bpd when I’ve made it more than clear in this blog that I don’t agree with that diagnosis.

However, my cc said there are two parts to my issues; one being the PTSD and trauma and the other being social problems (i.e. being isolated, anxious and depressed). The thought process of the psychology department is that these two options deal with both parts. Option one is one after the other and option two is at the same time.

I really had no clue which one to chose but purely through the process of elimination, I have chosen option 2. This is because I really dislike the sound of dtc and I don’t think it’s for me at all. Option 2 is also shorter and I hope I’ll be out of services not long after completion.

I should be feeling happy and glad that something is finally happening and yet I can’t help but still have this bone of contention over my diagnosis and to be honest, i’m feeling very scared of finally looking my traumas in the face and trying to overcome them!

 
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Posted by on November 20, 2013 in Uncategorized

 

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Psychiatry Appointment

Tomorrow I have my quarterly appointment with my psychiatrist. It is essentially a catch up, making sure the meds I’m on are ok and if they need any change in the dosage.

However, after last weeks therapy assessment outcome, I feel I need to get everything off my chest. I told it all to my cc but as she is off she told me she wouldn’t have chance to explain my thoughts to my psychiatrist before my appointment.

I’m ok with this, I am more than capable of expressing my thoughts and opinions to my psychiatrist. I have a lot of respect for her, we have clashed heads somewhat in the past because we both speak our minds, but I also like her for that reason. When my cc realised she was off on the day of my appointment she said she wasn’t worried as I can more than hold my own, so now I just need to!

I’m pretty nervous about it, but only because I am still so annoyed about last weeks recommendation. When I spoke to my cc about it, she said we will review it when the therapists report comes through and that it isn’t a no, but just a not today.

I asked her how the circle can be broken because from my perspective they are saying I’m too high risk, but the reason I am high risk is because of the images and thoughts that are constantly going through my head with the trauma. I don’t need emotional regulation, I need help with the flashbacks and the fact I’m scared to sleep. I’d like to see how anyone (without trauma) deals with 2 hours sleep a night – if affects the mood in a massive way.

Using an analogy, I also told my cc that I feel that I’ve gone to my GP two years ago with a sore arm (PTSD symptoms) and initially they have tried treating that, but then they’ve seen a problem with my leg (even though I’ve never had any issues with it) and they decide to concentrate on that. And last weeks assessment makes me feel like they are recommending putting my leg in plaster and I keep saying but what about my arm? That’s my problem, why can’t we treat my arm?

I’m not sure how all this will come over to my psychiatrist tomorrow, but I can only hope I fight my corner well enough!

 
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Posted by on July 28, 2013 in Uncategorized

 

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I’m so Angry!!

A pre-warning that this is going to be a total rant and might trigger some so please be careful.

Today I had my last therapy assessment session. The whole point of the past 4 sessions has been for this new therapist to assess what he thinks about the usefulness of cat therapy and art therapy. Throughout the whole process he has asked me what I think will help and I’ve told him I don’t know, that I’m putting my faith in the professionals.

But today, I wish I hadn’t! I arrived and he said we were going to discuss his recommendation and that he didn’t think I would benefit from 1-1 therapy. He told me about a group called ‘democratic therapeutic community’. It’s a one day per week group that, as the name suggests, is run democratically by service users. His logic behind this is because I’m caring he thinks I’d gain a lot from helping others. I told him that it’s taken me a long time to realise that although I do enjoy helping others, I need to look after myself first and deal with my issues.

I’ve only just got home and to honest I am absolutely furious. I can understand how the group environment would be useful later on but right at this minute, absolutely not. I wouldn’t for a second think I have the knowledge or training to help others except in a peer level and with respect to them, I feel I need someone who is qualified to help me.

Not once, has anyone asked if I’ve ever wanted to talk about what has happened to me. It seems modern day therapy shy away from discussing the actual trauma and to be honest, I just need to get it out. It’s eating away at me, the things I’ve seen, been made to do etc.

The therapist asked me what I thought of it and I told him I didn’t think it was a good idea. That my issues are rooted in the fact I struggle with flashbacks and therefore sleeping which in turn affects my mood etc and I need help with those things, not emotional regulation.

I’ve read the information booklet he gave me and it says it’s a successful treatment program for people diagnosed with personality disorders. And here is my issue yet again, I do not believe I have one!! As shown in an earlier post, I think complex PTSD is my diagnosis and yet here they are seemingly treating me for something I don’t have – this was my point initially that as soon as you have that label then that’s all they concentrate on. I’ll put it simply – my mental health is suffering because I was brutally raped, I saw someone die, I had a gun pointed at my head and the trigger pulled (learning only at that point it wasn’t loaded), I was made to be sexual with a dog and they are just the tip of the iceberg. How the hell can they come to the conclusion that I don’t need a qualified therapist to help me???

I’ll be honest, I’m devastated. I’ve been led to believe, from the beginning, that therapy was the thing that would help me. I feel I’ve invested everything they’ve asked of me in to the process and then to be told ‘well actually we believe peer support is what you need’ is basically a pile of bullshit!!

 
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Posted by on July 23, 2013 in Uncategorized

 

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Psychiatrist Appointment

Today I had my quarterly psychiatrist review to see how I am getting on and if anything can be changed with medication etc. Normally my care co-ordinator is there as well but she couldn’t make it today so it was just me and my psychiatrist. I actually get on quite well with her, I think she is fair and I know that she backs the high risk management plan my care co-ordinator uses with me and without her, I’d be in a very different place right now.

Each appointment basically takes the same brief outline with questions such as:
How are you?
Do you think you are better or worse than last time you were here?
How do you think your meds are working?
How is work?
How do you see your future?
etc…

I generally struggle with these appointments because it feels like you have to bare your soul and then just be able to switch off all emotions once you’ve done that. It was all going ok until she asked about work and I told her about recent issues with my main client and with a smaller one which has left me with little income (I’m self-employed). In response my psychiatrist said she doesn’t think I’m fit for work and I should think about stopping it altogether at the moment.

I can see where she is coming from but I also think work has given me the incentive to get up at times and taken my mind off things. It has helped with my self esteem as I’ve known whilst working, my clients see some worth in continuing with my service and therefore that I am good at something.

We also spoke about suicidal thoughts and my recent overdose. I explained that I’m currently struggling daily with thoughts but they have just been thoughts. I told her that I have the means and a plan but that’s all and the last time I seriously thought about it was this morning but my plan needed darkness so I didn’t do anything. I guess this shows me how precariously on the edge I am – if it was dark and I had those feelings would I have gone through with it? I can’t answer that right now!

My psychiatrist then told me that on Friday, her, my cc and a psychologist were going to be meeting to discuss the way forward in terms of therapy. Is this not something they think I should be involved in? I only hope they are meeting to discuss options and not to make a decision as I honestly believe I need to be part of that final choice.

The next thing we spoke about was my medication and how I was finding it. I said I felt the promazine (for night anxiety) wasn’t as effective anymore and that I’m not sure the fluoxetine (anti-depressant) has ever been much use. She explained to me that she didn’t believe I had a major depression and so didn’t think upping my anti-depressant would help. Instead she believes because I have been victim of severe abuse, this is just the reaction to that abuse.

To be honest, that has completely thrown me. When I had depression as a diagnosis, I could tell myself, it’s ok, your brain isn’t working properly and that’s ok. But now I feel like this is my fault, that it’s about my ‘reaction’ and therefore I’m in the wrong.

I always remember an equation someone taught me; e+r=o (event + response = outcome). They said that the only thing you can control in that equation is your response to change the outcome. Now all of a sudden I am being told its my response to the event that is leaving me feeling this way, and that I have full control of that response (as opposed to only some and depression the other), I feel like a complete failure.

So basically the outcome of today was that

 
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Posted by on March 12, 2013 in Uncategorized

 

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New Therapist

Today I went to meet my new therapist. My last session with my previous therapist was in November before she went on maternity leave, so it’s been a couple of months. I’ll admit to feeling rather anxious, things haven’t been easy over the Christmas/New Year period and I feel on a very tight rope at the moment.

Taking all this in to account, I still went along today with an open mind. I remember first meeting my last therapist and having reservations about her. I thought she was too ‘fragile’ and didn’t feel able to speak my mind. Once I overcame this obstacle though, we forged a good relationship and by the end, she knew how to help me and get the best from me.

I know this took time to grow and so I knew that any new therapist I met I’d have to go through this process with. If I’m being honest, I don’t think I ever accepted the end of that last relationship. It has felt more like she has been on holiday and it was only going back to the offices today and seeing someone else that it has sunk in.

The fact is, the new therapist needs to understand me by asking me questions, being around me and seeing how I work. No amount of notes will give that kind of information and I understand this and am ok with it. What I don’t want to go over is the facts and basics of why I’m there, they won’t change from what is written down.

Today, I feel like I’ve had to explain my situation to someone who has never heard it before and that takes a lot from me. I don’t need right now to be reminded of it all, I need help to deal with the thoughts, the nightmares, the flashbacks – not to be triggered to all this.

This is personal preference, but when in therapy, I don’t like note taking. I feel it creates a barrier and on a number of occasions I had to repeat myself as she was writing previous thoughts whilst I’d moved on. That’s fine for some, but it takes me a lot to say it the first time and I just don’t feel like I want to sit repeating myself.

I know each therapist has their own style and no two are ever the same but I thought there were certain things they are trained in. For example, if unclear, ask and don’t make assumptions. This didn’t seem to be true today and I found myself getting frustrated because I kept having to say no. For example (and this is a stupid example) but I told her I felt being back in therapy was like having a mountain in front of me and that the top of the mountain was feeling how I did with previous therapist and therefore able to carry on where I left off. She thought I meant that therapy as a whole was a mountain and so I tried to clarify that I meant coming back in to therapy, not the process as a whole. After 10 mins of trying to explain what I meant, I gave up. The problem is, I generally work in analogies, it allows me to express my thoughts and everyone I’ve worked with so far has got this part of me straight away. However she seemed to make assumptions and once that had been made, wouldn’t change from it.

To be honest, after the appointment today, I have been left thinking that I don’t know if therapy is the right thing for me at the minute. I feel in too vulnerable a place for this. It has left me in a very low place.

 
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Posted by on January 2, 2013 in Uncategorized

 

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Decision Time…

So the time has come for me to make a decision about the next step in therapy. Tomorrow I have a meeting with my care co-ordinator, therapist and psychiatrist to make this decision. I’m really grateful that they are allowing me to maintain a certain amount of control in this process but part of me is really nervous about seeing all three of them together (ridiculous eh!!)

Over the past week I have spoken to both my therapist and cc separately, to try and come to a decision. My therapist thinks that carrying on as me and her have been doing is a good idea and therefore I will be passed on to another cbt therapist (although it’s not cbt that we’ve been doing!). And when speaking to her, that sounded the best course of action.

And then after speaking to my cc who thinks a more explorative therapy might be useful, I tended to agree with her. I guess I don’t actually have an opinion on this. I don’t know if a certain type of therapy has helped me or it’s just the therapeutic relationship that has. The fact I’ve been able to go somewhere once a week and offload has probably been the most important thing for me.

I’ve asked my therapist in her experience, will I benefit from more of the same? Both her and my cc have agreed that it depends on how I get on with the new therapist and there is no right or wrong answer. If it doesn’t help me the way we think it should, then I can be switched (but that switch would involve going back on the waiting list).

I guess I’m just really confused and tomorrow I need to make a decision!

The other thing that is bothering me about this whole period is that I know I don’t let my defences down easily and trust is a difficult thing for me. I will miss the ease of turning up for a session and being myself without having to explain things too much. To build a new relationship is going to take time and the month of december is really not the best time for this to be happening. Whichever route I take, I’m likely to have a few weeks with no therapy and this coincides with the anniversary and if anything is the time I need support around me. I’m pretty worried how I will deal with this to be honest. Then for good measure just throw in the ‘c’ word, which is an incredibly triggering time for me, and this upheaval is something I could do without.

**Update**

So I met with all 3 of them (a very surreal experience) and I think it had pretty much been decided by them, and me separately, that things would carry on as they are but just a different therapist. I was asked how I wanted the new therapist to be introduced; in my current sessions, with my cc or on my own. I picked on my own (you have to do it alone initially, so why not now!!). Both my cc and psychiatrist said at same time, “I knew you’d say that”. Apparently my stubbornness doesn’t just come across on here 🙂

It was also nice for my psych to say they’d all noticed how much effort I’m putting in to sorting things out and really pleased with that side of things.

 
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Posted by on November 11, 2012 in Uncategorized

 

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Therapy update

Last month I mentioned that my therapist was going on maternity leave and that I’d been told I would be put back on the waiting list (6-9months) in order to carry on.

Today I had an appointment with my care coordinator (cc) and she’d spoken very briefly with both my psychiatrist and therapist this morning so they could all arrange a meeting to discuss properly. It seems now, that my cc has been fighting my corner, and it looks like I won’t be taking a long break – which is great!!

The options that are flying around at the min seem to be three fold:

1) They are replacing my therapist on a part time basis and so would be for her to take over. However my current therapist doesn’t want the remaining time to be a handover period because we are going through a really rough patch, but one we are pushing through. This is essentially the nightmare exposure work I’ve mentioned. It is extremely difficult for me to deal with it all and the other memories that are coming through are making me sleep deprived and emotional to say the least!! She thinks we are at a crucial stage and introducing someone new into my remaining sessions would be counter-productive. The alternative for this is for the new psychologist to be introduced to me via my cc appointments.

2) I see an existing therapist who they think is easy to get on with and therefore I could build trust and rapport relatively quickly so we can start off from where I left off. There would be a break until she gets a slot available for me.

3) To add an extra session with my cc and do some self help stuff (like dbt) with her having supervision from a psychologist. At the same time, I would be put on one of those original waiting lists for 6-9 months.

I’m really pleased that we have a lot of options now available, as opposed to the original plan I was told! Apparently everyone is really pleased with how hard I’m working at the min in terms of therapy and lack of self abuse and all three of them see me being able to get better (be it a long path I’m on)

In terms of the above options, I’m not too sure which I’d chose. I don’t think I like the thought of 3 as I see my relationship with cc completely separate from any kind of psychology work. But they have arranged a meeting in November and whilst they want to sit and chat about it for half an hour, they then want me in for the second half. All three say I know my mind (aka stubborn!) and have not only a valuable contribution but also the ultimate say in the next step. It feels like I’m in control of the situation and for someone who has been through what I have, it feels right.

 
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Posted by on October 15, 2012 in Uncategorized

 

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