Monday, June 10, 2013

PTSD Awareness Month: The Therapy Option

     The first piece of pretentious wisdom every overbearing, annoying, sometimes infuriating, know-it-all imparts to you once they realize there's something "wrong" with you is

     "You should really go to therapy."


     (I know. I should tell you how I really feel.)

     But for some reason telling people how you really feel is the end-all be-all in some minds for any type of problem. Some people think therapy is the answer, but they forget that the question is different for each person.

     So, I present to you my thoughts on the therapy option.

     First off, therapy is an option. It is not a mandate (unless there is a court order involved). Anyone forced into therapy will not benefit from it. The number one rule of therapy is that you only get out of it what you put into it. If a loved one really wants to help a fighter, he or she should let the fighter have control. My first excellent therapist once described trauma to me as someone else having control without your best interests in mind. If loved ones take control over the actions of the fighter, whether or not they have the fighter's best interests in mind, the fighter can easily relapse into trauma-reaction mode. That is certainly not helpful. It's much easier for me to consider therapy if it's presented to me as a possibility rather than as something I must/should/need to do.

     Second, therapy is not necessarily all of the answer. As helpful as discussing problems can be, sometimes more action needs to be taken to solve those problems. While therapy helped me, it was not until I left my instigator that I could really get the help I needed. Actually leaving the situation was the key. Therapy pushed me toward that and helped me with the fallout from that, but I had to take an action outside of therapy for anything to get better.

     Third, therapy is very diverse and specialized. There are many forms of therapy for PTSD. I have participated in your run-of-the-mill "let's talk about what's going on and take a second look at your perceptions" type of therapy. This was helpful, but it could have been much more so if the therapist I had at the time was different. (The two of us did not click well.)

     My first excellent psychologist helped me with EMDR, Eye Movement Desensitization and Reprocessing. While I don't necessarily agree with everything posted on this website, the "For Laypeople" section does give a good overview of what EMDR entails. The idea behind this therapy for PTSD is that eye movement is connected to memory. My therapist would ask me to think about something that had happened as I listened to tones and visually followed her hand movements. It was an intensive therapy (I went twice a week), but it definitely was the kick-start I needed in getting rid of nightmares.

     After moving away, I found a new therapist who specialized in Cognitive Behavioral Therapy. This form of therapy focuses on reprogramming your brain. When your brain goes through a thought pattern, it's much easier to go through that same pattern again. Trauma creates unhealthy patterns; CBT tries to re-pattern those automatic thoughts. Again, I'm not agreeing with everything on this website, but it will help explain CBT. My therapist and I would work through "Challenging Beliefs" worksheets, which asked what trigger started a panic episode, what my "stuck point" was (the unhealthy thought that my brain kept going to), and whether that stuck point was true or not. We also went through modules about topics such as trust, power, and intimacy and identified stuck points for each of those.

     These are just two of the most common types of therapies for PTSD. There are many more. What works for one person may not work for another person. There is no one-size-fits-all form of therapy. Even for different times in life, different therapies can be better than others. So the diversity of therapies available make the idea of an omnipotent therapy ridiculous. Some work better than others at some times with some people.

     Fourth, therapy experiences are reliant on the relationship between the psychologists and the clients. I've had some less-than-awesome psychologists (one of whom simply blamed my parents for everything wrong in my life) and some incredible psychologists (who have been some of the most vital parts of my support system). Discerning between the two is difficult. One good way to differentiate is to find reviews of different psychologists. Often talking to psychiatrists, family doctors, or members of support groups can help you find a good psychologist. Something that I've found helpful is to meet with the psychologist and get to know them. What type of clients do they see? Do they have experience with trauma survivors? What kinds of therapy do they do? Most important of all, determine what the dynamic is between the two of you. Do you trust them? Do you like them? Do you see them as your first line of defense in your fight, other than yourself?

     All of these complications make the statement "You should go to therapy" simply frustrating for me to hear. There are a lot of factors that should go into the decision to go to therapy. While I know that I would not be where I am today without therapy, I also know that it's not the answer to everything. Each person and each situation is different. So if you want to suggest therapy to someone, remember that it's an option that might be helpful but is very diverse and is reliant on the therapy relationship.

     But what if a therapist suggests some additional type of treatment, especially medication?

     I'll share my thoughts on that next time.

Take care,


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