Trauma Focused Counselling, Psychoanalytic Therapy & Bridging The Gap

By now I have had nine sessions with Z. Only, it’s turned out very different to what I had thought it would be. Two sessions ago Z. said that she felt concerned about us doing deep trauma-focused work, said that she wasn’t sure it would ultimately be to my benefit if we started unpacking memories that would undoubtedly cause a lot of pain, when we have so very few sessions together and might not have enough time to get any closure. She also said that she was unsure if we should do all sixteen sessions as planned, or if we should perhaps instead spend a few sessions thinking about how the work we have been doing so far could be brought back into A.’s consulting room. Or, Z. added, maybe what we need to do is look at sorting out a referral to someone else, someone who specialises in trauma-treatment, but who – unlike herself – could offer long-term therapy?

All this came as a bit of a shock to me, because, after all, Z. had been handed my referral and would have known the extent of trauma I have suffered, and she also knew the premises we were working on from the outset: sixteen sessions, no more, no less, unless I decided to cut counselling short. Of course, intellectually I can appreciate the concerns voiced by Z., but it was still a tough one to take in. Also – perhaps more importantly – I know myself fairly well, and I could see right away that no matter how much intellectual sense this proposal made, it would only be a matter of time before those deep seated, fear infused questions started popping up in my head and heart: Was that really the reason why Z. wanted to cut counselling short? Maybe this was just what she was saying, because she didn’t want to tell me that I had once again become ‘too much’? What if the real reason was that the stuff I had shared already was more than she could cope with? Needless to say my internal Here-We-Go-Again alarm bells were going off like crazy.

Of course, the rational part of me knows that it is unlikely that Z. would lie to me, or that – given that working with trauma is What She Does – the bits and pieces of trauma I had let her in on would be too much to cope with, but as we have seen time and time again, intellectual understanding and emotional response rarely go neatly hand in hand in perfect harmony. As I said to Z.; in many ways it doesn’t even matter what the real reasons for not doing the full sixteen sessions actually are: ultimately it will almost certainly become cemented in my mind as further proof that I’m ‘too much’. Or, even, that I’m not really worth the hard work that is involved, because, after all – everyone else gets their sixteen sessions, and they’re all trauma clients, too. So, this must be something specific to me.

I told Z. that, although I’m nowhere near as invested in my relationship with her as I am in my relationship with A. [yet], an experienced rejection of this kind would still bring all these fears to the surface in a way that I don’t think would be particularly helpful for me, as it would only serve to reinforce the idea that no one can truly cope with me. That no one wants to hear my story.

I feel quite pleased with myself that I managed to share these thoughts with Z., that I didn’t do what I would have done a few years ago: bury all feelings as deeply as I possibly could, right at the very edge of my conscious mind, and just accept Z.’s suggestion to end counselling early – with a bright smile plastered across my face to hide the invisible tears, to boot. I’m glad that I instead decided to ‘fight back’.  [Especially as Z. told me in today’s session that we have another seven to go, which means we will be doing the full course.]

The two sessions since Z. suggested stopping short we have spent, in part, at least, exploring what this proposition of Z.’s has done to me and how it has made me feel about Z. I’ve also explained that I am not looking to find a new therapist; I think it is crucial that I somehow find a way to bring the work I have started with Z. back to my sessions with A., both to allow me an opportunity to discover that I can overcome my fear of breaking people [and perhaps even of breaking myself], and for A. to rise to the challenge and earn my trust back, so that I dare once more take a chance and share some of the truly awful things that happened to me. To, in a sense, come full circle.

A.’s and my story began a little over four and a half years ago. It took me a good year of testing A. in a million different ways to make sure that she was for real before I even considered talking about anything much at all. After that another two years were spent slowly slowly building a genuine relationship. I began trusting her, tried to open up even when I was terrified to do so. And then in year five of therapy – boom – something went quite badly wrong. Both A. and I hit a wall, full speed, from opposite sides, and whatever trust there was got seriously dented as a result. And that’s where we are at now: we are both still in recovery mode.

What I would like to add to our story is a final phase where I get to experience that mutual trust can be rebuilt. Both that I can start trusting A. to ‘hold’ me again, to feel safe with her, to know that she can cope hearing about the things that happened to me, but also that she can regain her trust in me. It would be unrealistic and unfair to suggest that the breakdown and subsequent dent in trust was experienced only at my end; I can absolutely see that the act of nearly killing myself earlier this year, put a dent in A.’s trust in me, too.

This is the main reason why I don’t want to look for another long-term therapist, even if she happened to be specialised in trauma-focused work. I feel that the positive corrective emotional experience needs to happen in my relationship with A. The circle needs to be completed in a single relationship.

I do feel that the work I have been doing with Z. – both the trauma work and the work we have been doing in the last two sessions – has been helpful to me. It has made me try to, ever so gently, bring some of the feelings around the abuse into my sessions with A., to lower my guard that little bit more, and it has also helped me be a lot more direct in the way I communicate with A. about our relationship. I do a lot less tiptoeing around. I still feel that I want to complete all sixteen sessions with Z., because I think the time left could be well spent building bridges. I also think it’s been quite healthy for A. to see how I have responded to a very different type of therapist/counsellor, and I think it has made her reflect on the way she works with me, and what may or may not be useful in our work. I don’t mean that this has been a forced response to a threat of If you don’t do things MY way, I’ll find another therapist, because I don’t feel I have issued such a threat – the decision to do trauma-focused work outside of therapy was made before A. and I hit that wall, had been discussed in my sessions with A. – but that it’s happened naturally, on a genuine feeling level.

There is still a long way to go, for both of us, but I think we will get there in the end.

xx

PS. Following my last two posts I have (a bit surprisingly) had more than one email asking if Z.’s real name is Zoe Xxxxxxx, so I thought I’d state once and for all that NO, it isn’t. Z.’s name doesn’t even begin with Z, I just randomly picked it because her letter was already in use. As I’ve said before, I do always take as much care as I possibly can to mask other people’s real identity, and this includes the identities of my counsellors and psychotherapists. :)

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The Beginning Of A Parallel Journey

My most beloved transitional object

My most beloved transitional object

 

You may remember that a few posts ago I wrote about deciding to go ahead and do some short term specialised trauma-focused counselling, parallel to the psychoanalytic therapy I am already doing with A.

I set out on this journey four weeks ago and it’s been quite a ride thus far, but before I begin writing about said journey, let me introduce you to a new character: Z., my counsellor. I have to admit that when I met her the first time I wasn’t entirely sure about her. My impression was mostly positive, and I absolutely felt that she was someone I could work with, but there was also a little bit of fear that she might not be quite strong enough to resist my habit of luring therapists and counsellors alike down side paths and blind alleys. What I mean by that is that, in the past, back when therapy was something I was doing because someone else wanted me to do it [parents, doctors, psychiatrists], I was very very good at finding ways of showing up for session each week, skilfully avoiding doing any actual therapy.

What I did was to go in and talk about something entirely unrelated [I spent an entire year talking about ice-hockey and the LA Lakers with my first therapist], then dazzling them by intellectually linking whatever I had decided to talk about with psychotherapeutic theory. I realise, of course, that this was something I did because I simply wasn’t ready to engage in therapy, so in one way this behaviour is hardly surprising. But, at the same time, there was always a part of me that was deeply disappointed that none of my first three therapists ever pulled me up on my fairly obvious attempts at outsmarting them, and that they were instead, session after session, drawn into complex discussions about attachment theory, projective identification etc etc. I think what I was really craving was a therapist who would step into that pseudo-parental role, different to my own parents, steering a clear path in showing me that they were more interested in me than in my ability to spin intricate and dazzling webs.

It wasn’t until many many years later in my very first session with D. that a counsellor finally told me that ‘Although your knowledge is very impressive, it’s not why we’re here.’ Felt like hitting a brick wall at a hundred miles an hour and then being told that it’s pretty silly to go running at a wall, when there was a perfectly good opportunity here to learn to use the ladder that was leaning against said wall. I’m not saying that D. was necessarily the first counsellor or therapist to see through this game I was playing, or to understand the reasons for why I was playing it, but she was the first person to properly make me feel that she understood that I was absolutely terrified and that rather than allowing me to carry on defending against this fear by using intellectualisation she cared enough about me to want to help me step onto the ladder and do something different. There was no pressure to make it to the top of the wall in the time we had, but instead there was a lot of focus on acknowledging the achievement of making it onto the first step. Any subsequent steps would be a bonus.

So, knowing that I was about to begin a completely new type of counselling with Z., one which focused solely on the sexual abuse I suffered, one where talking about my parents, or being adopted, or the million other things that are part of my life and who I am, would play very little part, I was completely and utterly petrified. Thus, meeting Z. for the first time was a big deal. Naturally, meeting a counsellor or therapist always is, but I was very aware of the need to find a counsellor who wouldn’t gobble up deliciously smoked red herrings thrown their way, and so there was a lot on the line in that first meeting.

Coming out of that meeting, my general impression of Z. was – as I said earlier – mainly positive, there was still a part of me that felt concerned that her statement that she ‘wouldn’t push me to go somewhere I didn’t want to go’, might potentially indicate that she was someone who, if I wanted to, I could easily string along in an attempt to not only avoid having to go to painful places, but to avoid challenging myself to move forward at all. Like I said to my sisters after the first session: ‘Z. is someone I would have had for lunch 10 years ago’.

But the four and a half years of doing therapy with A., along with the counselling I did with D. prior to that, has made me realise how much there is to gain from doing my utmost to stop myself from going down that route. To, in a sense, stay on that ladder and keep climbing it. So, I knew that even if I was somewhat unsure of Z., I knew that I was different, as were my reasons for going into this counselling. Of course, as much as I try to consciously stop myself from hopping off the ladder, there may still be a fair amount of unconscious [or subconscious, if you’re so inclined] motivation for leading myself astray, hence, needing to feel sure that Z. would be able to spot this when I can’t.

In my second meeting with Z., many of my initial fears were laid to rest. She came to the second session with a very clear view of what she would like us to work on and helped guide me through it. This is very new to me; I’m used to doing psychoanalytic therapy, where I’m pretty much always in the driver’s seat, and it’s a real challenge to now, suddenly, let someone else co-pilot. There were some things Z. had wanted to do in the second session, which she soon realised weren’t quite right for me, as they were things I had already worked out and implemented for myself, and she swiftly adapted to this, changing course to suit my trajectory. This lead to something I would never in a million years have thought possible: already in session three I took a plunge and showed her a drawing of one of the abuse situations and talked about it. It was scary as anything, but was much helped by discussing – prior to me handing the drawing over to Z. – what I wanted her to do with it so as to not have a repeat of that session with A. where I interpreted her immediate return of a drawing as a sign that she couldn’t quite bear looking at the reality of the abuse. Instead, this time, we made the agreement that Z. would hold on to my drawing until I indicated that I would like to have it back. Z. also showed some initiative when she felt I was getting into my normal way of racing ahead through a story, as though I’m talking about someone else, with complete emotional disconnect, by stopping me for a while and asking me to reconnect and to tell her what talking about this made me feel. This is very new to me. Naturally, A. is also very interested in what I’m feeling, and often tags a ‘Can you say more?’ [one of my absolute favourite questions] or ‘Can you unpack that?’ onto something I have said, in order to coax more out of me. But, I’m not used to being actually stopped in order to reconnect several times during a session.

I had brought my beloved Doth with me to session. Doth, for those of you who haven’t had the pleasure of meeting her, is a porcelain doll I’ve had since I was a child. She was made by my best friend’s mother and she was the only person who knew about the abuse while it was going on; I used to sit with Doth, whisper in her ear the things my brother and M. made me do. So, needless to say, she is very very precious to me, and as childish as it may seem, I thought having Doth with me in session might make it easier for me to talk about the abuse, because, in a way, she has already heard it all. I felt regressing to that childhood ritual of talking to Doth about the awful things that were happening might help me overcome my fear of talking about the abuse for fear of breaking the listener.

I think this parallel work with A. and Z. has the potential to be a very good thing. I had worried that I might be spreading myself too thin, or that it would become too confusing working with two people at the same time, but for now it seems to work quite well. Also, the work I am doing with Z. is very short term, only sixteen sessions in all, and is by its very nature a lot more intense than the therapy I’m doing with A., and I am hoping to use my sessions with A. to ensure that I remain safe while I’m doing this very painful work. I have already noticed that I am again having more flashbacks than the norm, but this is something I had expected. As I told a friend of mine: ‘Doing this was always going to be a totally rubbish time’, but I am hopeful that it will ultimately help reduce the amount of flashbacks I have, and also, that it will help me go further with A.

Sixteen sessions, even if structured, is not a lot of time, especially given that I suffered abuse from more than one person, and that the abuse went on for as long as it did, so I am hoping that doing this with Z. will open the door to carrying on talking about the abuse with A. once counselling comes to an end, much in the same way that the counselling with D. set me up for actively trying to avoid throwing red herrings at A., and subsequently, Z.

 

In other words: onwards and upwards, one rung at the time.

 

Be kind to your Selves,

xx

 

Long-Term Psychoanalytic Therapy & Short-Term Trauma Focused Counselling

I have been meaning to update my blog for a long time now, but blogging has had to take a step back in the midst of coping with what has felt like an ever-increasing onslaught of flashbacks. Still, here I am now, neatly posed in front [well, technically, behind] my computer and though I will more than likely have to make many stops to work my way out of flashbacks, I still wanted to write a little, just to keep you all in the loop as it were.

Firstly, I would like to apologise – or perhaps not so much apologise as acknowledge that my previous post was of a rather difficult-to-read nature. I know that some people found it a little too hard to cope with. And, at the same time, I have also had emails from people saying that they found it helpful in one way or another, and I suppose, at the end of the day, this blog, it is – as it states on the tin – an honesty focused blog, and does come with an explicit warning that it sometimes deals with difficult issues.

Now, moving on from that, you will be pleased to know that this post will be perhaps a little less difficult to stomach. I can’t guarantee that it will necessarily be joyful, but it won’t be leaving you with any particularly nasty mental images, I shouldn’t think.

So, what’s been going on in my life? Well, as mentioned above, there have been the flashbacks, and sometimes it really feels like that is ALL that there is, but, really, that’s not true, and I am hoping that – eventually, with plenty of hard work – I will get to a place where those will take a back seat.

As regular readers will know I am currently in twice weekly psychoanalytic therapy, and have been for nearly four years [thrice weekly, a lot of the time]. In fact, A.’s and my four year anniversary is coming up later this month. Perhaps time to crack open the champagne, or share a celebratory cigar ála Freud? But more than anything, I think, time to reflect.

People often ask me if my therapy helps, and what does A. say about all these flashbacks that I’m having, about self-harm, about feeling suicidal? And I find myself forever explaining that it’s not that type of therapy. It’s not the type of therapy in which A. and I sit and practice grounding techniques or where she advices me on what I should and shouldn’t do. It just isn’t. Psychoanalytic therapy isn’t a short term crisis action plan. But that is not the same as saying that my therapy isn’t helping. No, it doesn’t immediately offer relief from flashbacks or other psychological ills, but it helps in different ways. It helps me see things from different perspectives, it helps me develop self-awareness, it helps me understand why I sometimes react very differently to other people, it helps me see patterns in both my behaviour and in my way of thinking and relating. It helps me in a very broad way. This is not trauma focused therapy. We look at a lot more than ‘just’ the sexual abuse I experienced, we look at all different aspects of my life. It’s colour photography, as opposed to black and white, and I feel that it offers a bigger and more stable platform to stand on, when looking at all the various angles of being alive and being human. So, yes, therapy absolutely does help. It’s just that it is rather more complex than a plaster cast on a broken arm.

That said, the one thing that impacts my day-to-day life more than anything else is without a shadow of a doubt the flashbacks, the horrible experience of being made to relive the abuse again and again without warning. It’s a painful and uncontrollable mental bombardment which severely alters the way I live my life. Apart from, of course, being extremely emotionally exhausting (both the actual flashbacks and the aftermath of them – it’s simply not a case of OK, I’m out of the flashback, everything is fine now..) they also impact on a very practical level. Firstly, the unpredictability of when they [the flashbacks] are going to happen, means that it is very hard to relax. I don’t have easily identifiable triggers which give me warning that I might soon have a flashback, so, even when things are good, when I’m only having perhaps six or ten flashbacks in a day, I don’t know when they are going to happen, and so have to always be on the ready to deal with them. Secondly, when things are bad – like at the moment when I’m having anything between sixty and eighty flashbacks in a day – it leaves little time or energy to spare for doing other things. I can’t read, I can’t watch telly, because I’m constantly being interrupted by these flashbacks, and by the time I’ve come out of them and calmed down, I’ve forgotten what I was reading or what the storyline was. Also, having so many flashbacks makes venturing outside something to be avoided. It’s simply too hazardous, as I won’t notice traffic lights changing, I’ll keep walking while having them ending up getting lost, I’ll miss my stop on the tube etc etc. Even something so simple as making myself a cup of tea can become quite dangerous, as I discovered the other week; I was pouring out the water, had a flashback but kept pouring.. as a consequence the boiling water spilled onto my lap, and I got a burn on my thigh. So, even though the flashbacks are not psychotic; I do know where I am, it is like being in two places at once, it’s an altered state of awareness which affects daily life a lot more than people realise. I have to do a million different work-arounds just to get by, like being on the phone with someone whenever I’m out walking (so the person can help me notice if I have a flashback and tell me to stop walking), ask bus drivers and tube staff to make sure I get off at the right stop, meet friends in places that are easy for me to get to and generally meet at the station rather than at the cafe or restaurant we’re going to, to minimise the potential for getting lost on the way. Etc etc etc.

Because of this, I have decided that on top of my normal therapy with A. I am going to do some short-term specialised trauma-focused counselling, aimed at trying to reduce the number of flashbacks I have. I’ve talked to A. about it, and although it’s not the norm to see more than one therapist at any one time, it is something I really want to do. And I think that doing it this way, while I am still seeing A. will help me cope better with what can’t be anything but very painful trauma work. It’s one of those I don’t think it is meant to be easy, I think it’s meant to be WORTH it sort of things. Because, if it helped reduce the frequency of the flashbacks even just a little, it would improve my life enormously.

So, although there is much to discuss, not least of all the reasons why I am chosing to do this work with someone other than A. [is it to protect her? is it to protect me? maybe fear of ruining our relationship? etc etc], for now, I am waiting with some trepidation to start this new (additional) type of counselling. So do stay tuned. Updates will be forthcoming once I actually start.

All the very best,

xx