Therapy opinions please: To talk about past or stay in present?

[Sunfl0wer]

I am wondering everyone's opinions if you will.

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I have been in therapy for many years, on/off due to cPTSD from ongoing, different abuses until about early 20's. 

I recall having an awesome therapist who helped me through many years.  Often when issues of me becoming emotional talking about past stuff happened, she had a response: No need to "rehash" the past.  Instead of having me delve into what was coming up for me, she would have me sooth fast, quickly move back to focus on present stuff.

I came to think of dwelling on past stuff as mostly "bad" due to being redirected away from going there.  So I am currently trying to reopen my mind to redefine this for myself and undo my conditioning that considering the past = not productive.

This happened with another therapist from about 5 yrs ago.  Again, I felt I was getting some subliminal message to redirect myself to current matters and that looking at the past would keep me stuck.  So rather than intensely challenging her, I assumed the correct/healthiest/best thing to do to progress in treatment would be to suppress those past thoughts quickly and reorient myself to focus on today's issues.  Ya know, like thinking the only thing holding me back is my own thinking that can wander to past stuff.

Then another therapist I had last year.  He did same as explained in that one I just mentioned.  He even "rewarded" me for staying more in the present and such by explaining how he liked/preferred talking the way we were.  (Implying that the last visit when I was a bit overwhelmed, was not what he prefer to work with)

So here I am with a new therapist of just a few months I think.  I feel like in a way, I am supposed to learn to do the opposite.  I completely trust my current therapist more than the others and recognize that the others likely not trained in the same things he has been.  (I am also grateful to the past ones for their place in my life at the time)  Current therapist actually is more skilled with trauma work/other techniques, etc, than the others.  Others weren't much trauma trained.

I should mention, part of my PTSD is flashbacks and such and I do not really intentionally cause past thinking, so I do appreciate not feeling judged for thoughts that come up for me.

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Anyways... .

That was my long winded explanation for wanting you to share your thoughts on what you think has been helpful?
Have you had therapists avoid speaking of your past?
Have you had a therapist who is very trauma trained? Did their approach differ greatly?
Feel free to share how things helped or didn't help.
Thank you all!

[purekalm]

Hey Sunfl0wer,

That was my long winded explanation for wanting you to share your thoughts on what you think has been helpful?
Have you had therapists avoid speaking of your past?
Have you had a therapist who is very trauma trained? Did their approach differ greatly?
Feel free to share how things helped or didn't help.
Thank you all!

For me personally, I've had one therapist for about two years a little over five years ago. I was lucky to get placed with a woman who knew her stuff. (I say placed because it was court ordered for six months due to a case where my crime was not pointing the finger at my husband. I continued on my own for the remainder.) So, now I personally don't think I'll ever go to another because I just can't trust anyone since I'm looked at like I'm guilty without question.

Now, after saying all that, yes I do believe that working on history and trauma are EXTREMELY beneficial. BUT, especially dealing with PTSD, any therapist would use caution and take it slow as you're ready to deal with it. My therapist touched on things and right before she left she wanted to work on my childhood. (She got a better job.) She read me like a book, but gave me the time I needed to open up and trust, even a little. I received a lot of help from her, realizations and the like. I didn't believe everything she told me and I let her know it, and unfortunately sometimes not so nicely as my life had just imploded in the beginning. She seemed to like the fact that I questioned her motives and ideals, though not always. My experience all in all was a good one, and we did work on some inner child stuff that felt so weird at first. I think I laughed at her when she first mentioned it, but it's also dealing with the past by acknowledging the pain, letting go, healing.

From the sounds of your other therapists, they were not equipped to deal with the depth of your pain and had you focus on what they could do, right now. Right now is good, but a painful past will always affect it until it's dealt with and let go of, which as you and I both know, is much easier said than done. This is just my opinion and personal experience though, hopefully others will weigh in for you.

Sincerely,
Purekalm

[Sunfl0wer]

I appreciate the response purkalm!

I know this trauma work is different than anything I have done in the past.  This sounds arrogant, but the truth is that I started therapy at five yrs old and have been on/off since.  I feel it has all been useful, (well after 17yrs old when I actually wanted the T) and when it hasn't, I stopped.  Anyway, I pretty much got to a point with the last T or so thinking I knew all there was to know (that they had to offer) and really felt like there was not much left to learn from these people.  I felt like there was something missing in my therapeutic experience. 

I am sure that I am now finally embarking on that missing piece, and this feels huge.

I do wrestle with the concept of allowing the past to stay with me. (As is part of this trauma therapy) Part of me does feel it is contradictory to progress, due to ingrained past therapists, yet most of me feels that trusting this T is right.

So any thoughts for me to ponder to help me consider this other perspective... .Well, it is all helpful atm.  Thanks!

[thisagain]

I think there has to be a balance, and the right amount of past vs present can shift depending on your needs at the time. If you don't ever get a chance to talk about and really process the past experiences, the feelings are going to keep coming out in disruptive, painful ways. It sounds like your past therapists might have even made it worse by discouraging you from talking about the trauma  

As for my personal experience... .When I first started therapy, there was a lot of unpacking what had happened in the past (emotional abuse/neglect by my parents mostly related to their religious beliefs). Periodically the therapist would help me see, or I would realize on my own, how all that connected to how I feel and think in the present. That was really helpful to me.

A few years later, I went to therapy wanting strategies to soothe or cope with intense physical stress reactions during my pwBPD breakup. Like I really just needed to brainstorm ways to get through the day at work when I was shaking uncontrollably and had no sleep because of nightmares. I had a panic attack in her office just from describing a nightmare about my ex and the T really had no response. Instead she wanted to rehash all the stuff about my childhood, which was really old news at that point.

For a while during my BPD relationship, I went to a trauma therapy center where the theory was that you can't really recover from PTSD etc without digging deeply into the past trauma. (Long story on why I ended up there as I don't have PTSD and the panic attacks etc I was suffering at the time were because of my BPD ex... .But some of it was helpful.) The therapist would ask me to describe a scary childhood experience in a lot of detail. It helped me on a more visceral level to connect with the feelings from a long time ago and identify ways that my current situation was evoking similar feelings.

It's important though to keep a balance and work toward distinguishing past dynamics from your present life. If you intentionally dwell on past experiences in which you were a victim, it's easy to get stuck in that victim place. And when someone is stuck in the victim place, they feel helpless to make changes in their life or their relationship now as adults. My BPD ex went to the same PTSD treatment center for years and made almost zero progress in overall life functioning, her behavior in the relationship got and stayed worse, suicidal ideas and threats also got worse, etc. The therapy was so focused on going over and over her stories from the past, it really exacerbated her BPD tendency to see herself as a victim. The victim-perpetrator lens, while it may be accurate as applied to her child abuse, was not a functional way for her to continue viewing the world.

What kind of approach is your current therapist taking? How are you feeling about it?

[Sunfl0wer]

Thank you thisagain!

Yes, I can see the need for balance, and I do recall a past T connecting things to the past a little bit, just to show how my current feelings were based on past and triggered vs present day stuff, just then we moved away from that after establishing the connection.

For a while during my BPD relationship, I went to a trauma therapy center where the theory was that you can't really recover from PTSD etc without digging deeply into the past trauma. (Long story on why I ended up there as I don't have PTSD and the panic attacks etc I was suffering at the time were because of my BPD ex... .But some of it was helpful.) The therapist would ask me to describe a scary childhood experience in a lot of detail. It helped me on a more visceral level to connect with the feelings from a long time ago and identify ways that my current situation was evoking similar feelings.

Thanks for explaining this.  It helps a lot!  I unbelievably, have never had trauma therapy before now.

What kind of approach is your current therapist taking? How are you feeling about it?

Well, I am trying not to make everything about my DID, yet hard to keep it hush to not scare people, as well, it is so much a part of me.  So I apologize if this is uncomfortable to anyone reading, not at all meant to be.

I always knew I had cPTSD "with dissociative features." I just never knew those "features" were so well formed.  Neither did my other therapists.  So being actually treated for this "new" diagnosis is way different than anything I have ever experienced.

T uses many approaches.  He actually trains other T in EMDR, also does hypnosis which is good for DID.  Some T will not do EMDR on DID as it takes more skill, yet he is great and seems proficient/competent in all things DID.

So the issue is most of my Parts trust him and are very comfortable.  There is a Part of me that is having a hard time letting go of past beliefs that: rehashing is bad.  So trying to get more of me ok with it all.

[joeramabeme]

Hi Sunflower

You and I have talked about this and I have seen various posts talking about approaches to dealing with the past versus the present.  I say the following with the caveat that I am no expert but have personal experience and knowledge of trauma.

Trauma almost literally means to be stuck in the past and have no awareness of it other than bodily and emotional memories that keep recurring (triggering) without any attachment to the originating events that created it.  Think of it as if left and right sides of the brain have lost ability to communicate about an important event in your life and your left-side keeps reliving the experience while the right side has no idea about the originating event and so keeps making up stories and recreating situations to match the feelings.  That is trauma.  

EMDR is literally a way of joining the experiential/emotional part of the event to the intellectual memory of the same.  You did not indicate if your new therapist is trying to go back and unveil the past events?

My knee jerk reaction to those therapists that say leave the past behind and are treating those that have PTSD; is that they are under-informed and likely unable to meaningfully assist.  I have had similar "keep it in the moment" T's in my time.  They are helpful - from the perspective of practical day-day living advice, knowledge and awareness.  But IMO, you can give me advice all day long, but if I lack intellectual and emotional ability to connect related to trauma - it will not dislodge by simply focusing on current day events/indications.  It must be reconnected - which is going to mean therapeutically (with a professional) reliving a part of the trauma that happened.

Think of it as an allergy to pillows.  You go to be every night and each morning your T tells you to take an antihistamine, dust your house, get an air filter, etc.  Good advice!  But if they don't dive into what is causing the need, then beyond alleviating symptoms, what good is it.  You simply go to bed again and wake up in the morning with the same symptoms all over again.

From our conversations on this board, you indicated that you have cPTSD. And you know that there are professionals that deal with this very condition.  How long do you want to continue taking antihistamines?  

I have almost completed the book "The Body Keeps the Score", the author is founder of the trauma center in Boston.  It is all spelled out clearly in that book.  Again, I am no professional but there is plenty of professional information to support the idea that PTSD needs to be resolved by joining the past to the present - which is unlikely to occur if the focus is solely on the present.


JRB

[Sunfl0wer]

Thank you greatly for your reply Joeramabeme,

EMDR is literally a way of joining the experiential/emotional part of the event to the intellectual memory of the same.  You did not indicate if your new therapist is trying to go back and unveil the past events?

He doesn't need to at this point.  I pretyped and handed him my whole psychosocial history of trauma throughout my lifetime, the main highlights, and also included positive milestones.  He is not tying to dig anything up.  However, it pops up all on it's own for various reasons.  (A situation during the week, or feeling triggered, etc.)

Currently we are focusing on establishing more inner safety for all Parts of the mind/body.  We got through grounding, mindfulness, and now was last on more inner safety through guided imagery type stuff.  This whole stability/safety thing is phase 1 for the EMDR/Trauma therapy and what we work on mostly before we get to the processing of memories.  (Although part of safety means sometimes stuff pops up that needs processing)

From our conversations on this board, you indicated that you have cPTSD. And you know that there are professionals that deal with this very condition.  How long do you want to continue taking antihistamines?  

I appreciate your point on antihistamines, it does relate.  Most of me does agree that makes good sense.

I did out myself here in this thread and a few other posts on having DID.  I am not adverse to stating so, or having others state so, I just appreciate this community and do not wish to make others uncomfortable and cause any alienation unintentionally as some may think without DID then responding is not relevant or such.  I am sure everyone DID or not can relate to holding opposing views inside of themself and talking it out with others to help them find resolution of internal conflicts.

Like I said, most of my Parts feel this is the way to go, however, some feel like holding onto the belief that the past is the past and revisiting it is a type of negative rehashing.  

Humm... .
Yet, idk, this is still a non resolved issue in me.  I appreciate the viewpoints, thought it would bring some resolution, yet seems like more of something is needed. :/
Maybe we need to earmark it to discuss with T as we know that it is always a good idea to mention anything to T that may pose as a barrier to T.

Thanks for discussing tho!

Oh, I forgot, my point of the thread was to hope others can share their experiences so Part of me can relate to that!

Joe?  Mind sharing what your experiences were with T either Trauma related or non Trauma and how you feel it worked or didn't work for you?

can only post on my own threads here, so I do not mean to seem self centered here by never posting on others threads, just the way it is, sorry.

[joeramabeme]

Joe?  Mind sharing what your experiences were with T either Trauma related or non Trauma and how you feel it worked or didn't work for you?[/b]

LOL, hopefully you can read the other thread that I just wrote. Think I will pass on this question for the moment.

I wish you the best as you move forward with your recovery and would just restate that if you think PTSD is at the heart of what you need to address try reading, "The Body Keeps the Score" it will be very helpful.

JRB

[jhkbuzz]

I don't know if I'll explain this very well, but I'll try:

My current therapist is very, very good. A trauma therapist. I talk about the present AND the past, and we often talk about how the two are connected. But I've noticed that when I become very emotional or begin to approach "overwhelmed," she redirects my attention and asks me to engage in activities that calm me down. It's almost like part of the therapy is talking about the past/present and teaching my emotions how to remain on an even keel - sometimes right when I'm in the middle of something very emotional. It's like she's working to re-train my nervous system.

[boatman]

Hi Sunflower,

In my experience, I would talk about things that happened in the past and the emotions that were coming up in the moment as I talked. This will always be the case. Emotions occur in the present moment, they are part of our experience in the present moment. Every so often she would ask me how I felt in the moment of a past experience, but she always brought it back to my emotional experience in the room with her.

I hope this helps!