What type of therapy/treatment has worked for you?

Hate CBT. Hate it hate it hate it. Tried it with 4 different therapists, what a huge waste of time and money. That stuff doesn't work on me at all and just makes me feel worse.

DBT has been the only therapy that's helped me so far. I started it to help treat my BPD, but found it helped a lot with my cptsd symptoms.

I was with a very expensive therapist that did emdr but I was never able to get well enough to be able to do it :(

What has helped y'all?

Edit: The consensus seems to be IFS! Thanks, I'll check it out!

in CPTSDby Atsugaruru

100%

4.3y

nerdityabounds

4.3y

CBT works poorly for trauma, so it's not just you. This is not because anyone or any part is flawed, it's just not designed to work with the way the traumatized brain works. But, to quote Janina FIsher, CBT has a great marketing department. The best therapies for trauma are still finding the same footing CBT has enjoyed for 30 years.

Good alternatives based on my experience

Internal Family Systems or parts work based on the structural dissociation model

Somatic Experiencing

Sensorimotor Psychotherapy (DBT 2.0 with an included focus on the body)

Mindfulness based attachment work (ex, the NARM model)

EMDR works best when dissocation is low so if you have a lot of highjacking/flashbacks or "going blank", it may be better as a second tier treatment after the stabilization phase

If your trauma comes from your family of origin, someone trained in family systems theory will help immensely.

[deleted]

4.3y

Respectfully disagree. I have endured years of trauma and abuse and yet I found CBT to be helpful. True, it's not designed to treat trauma and it does little to help us understand the past. But the cognitive tools for understanding distorted perception and its effects on emotions is a valuable tool to help people get through the now. Really, all we do as humans is try to cope with our present state of distress, flashbacks not included. Anything that has a use is okay with me.

Also think it's odd that CBT gets panned while Dialectical Behavior Training is celebrated. They took CBT, added workbooks and renamed it DBT. These therapies are built upon the same tenets.

Atsugaruru

4.3y

The biggest difference between the two, imo, is that CBT focuses a lot on changing how you think and on your thoughts. DBT doesn't try to push that as much. It's more so for managing and learning to cope and deal with your symptoms so that they don't affect your life and relationships as negatively. What really bothers me about CBT is that most mental health professionals try to push it as a one size fits all treatment. It's really hard to find people in my area that are trained in something besides it.

I'm glad it worked for you though! That's awesome. Recovering from trauma and abuse sucks ass, hope your days have been a little brighter since you've gotten treatment

[deleted]

4.3y

You are right. CBT is very popular framework and it is very one-size-fits-all. That can be frustrating for people wanting to focus on trauma work. On the other hand, it's a great intro for someone who has never been in therapy and feels overwhelmed at prospect of digging up all that raw, long-burried emotion. People need to look at therapy and therapists like we look at cuisine. You're not going to get a taco at a Chinese place. If you're craving shrimp cocktail do not go to Burger King. One isn't better, they are different. I find most people do not bother to learn about the therapist they're seeing and then get upset when it isn't what they thought.

Atsugaruru

4.3y

I hadn't heard about those last three, thank you! When I read The Body Keeps the Score, I was surprised that he talked so much about healing the physical body from trauma as well. That's something I haven't tried, but thinking back at the few times in my life I had a regular exercise routine, it seems worth checking out

hippie_nerdy_gal

4.3y

DBT was a fucking life saver. I mean, years and years of CBT did nothing. One IOP DBT program changed my world. I honestly believe DBT skills should be taught in school... can you imagine how much better our lives would be if we learned those skills at a young age?

I tried EMDR, and it was a total failure. It actually made me worse... but ended up leading to a OSDD diagnosis, so I guess I'm glad it helped me learn more about myself. Because now I have a much clearer picture of what I need to heal.

In the EMDR process, I learned (and my therapist did as well, because she didn't understand the completely chaotic reaction I had to it) that people with undiagnosed/untreated dissociative disorders have really adverse reactions to EMDR. EMDR's whole premise is to help rewire all the different maladaptive parts in your brain so that they can communicate with eachother better. With dissociative disorders, those parts often don't know the others exist and it can be incredibly traumatic to all of a sudden give them little glimpses of eachother.

That last paragraph didn't really answer your question, but all that to say, I think it's really good that you and your therapist didn't push forwards with EMDR when they didn't feel it was the right fit for you. It could have been really harmful.

I am currently doing a combination of egostate therapy, internal family systems therapy, and EMDR with my therapist. We have switched gears towards treating the DD, not the CPTSD... I really like what we are doing now because its soooo gentle. Its all about loving and accepting the different parts in my brain, and finding out what they need to feel safe. The way we are using EMDR is really good too. We aren't processing trauma, we are using it to reinforce good things and emotions. For example, strengthening the nurturing part of myself by bringing up memories of times when I have been nurturing towards others while I hold the tappers.

[deleted]

4.3y

Are you able to tell me a bit about DBT? Is it something you can practice alone? I am not sure if the NHS would offer it D:

hippie_nerdy_gal

4.3y

I highly recommend the skills book by Marsha Linehan here . She created the DBT method, so that’s getting back to the original source and heart of the material. I actually think it’s a pretty decent therapy model to work through on your own, especially with that skills book. There are handout style pages with information and reading, and there are worksheet pages to practice the skills.

There are of course nuances and practical teachings that are better conveyed by a therapist, but you can get a lot of the core skills working through it on your own. There are also online communities that can help with practical applications of the skills (pretty sure there’s a DBT subreddit).

There is also a book that sort of accompanies that workbook, that’s a training manual for therapists. It’s available on Amazon as well and, if you’re up for it, is a great supplement to gain more from the workbook.

(To be clear, I participated in a DBT IOP, and was guided through the workbook by a trained therapist. When I was finished, I bought the training book for my own knowledge and to further my use of the skills, and found it to be very helpful.)

[deleted]

4.3y

You are a bloody legend thank you <3

hippie_nerdy_gal

4.3y

Happy to help! DBT changed my life.

Atsugaruru

4.3y

I had no idea emdr had that affect on people with multiplicity! I actually have DID, though I don't have access and can't communicate with my alters except for a few of the traumatized parts. My therapist acknowledged them but didn't really push me to talk about it. Did you find that your OSDD made the IFS therapy and egostate therapy more difficult?

hippie_nerdy_gal

4.3y

I actually think that IFS and egostate therapy is working really well for me because of my OSDD.

There is a bit of a language difference, in that the work I’m doing refers to ‘parts’ instead of ‘alters.’ Which, is something I am comfortable with, and also the parts I’ve been able to communicate with are comfortable with. For me (and my parts) we all recognize that our goal is integration... essentially becoming a more complete version of the ‘self’ with all of us included. So, by focusing on meeting the needs of my parts, and helping them all develop better coping mechanisms, the end goal for all of us is that they will feel safe enough and trust me enough, to integrate.

I don’t know if that makes sense. My therapy is combining multiple approaches into one, and it’s definitely highly tailored to my particular situation. I’m sure there are lots of people who would jump up and say we aren’t “following the rules” or we’re “doing it wrong” by combining different therapies... but, it works for me. I’ve seen real progress in my mental state since starting it, which is all I really care about.

Atsugaruru

4.3y

Thank you for sharing your experience :) Integration has worked for a lot of people. I'm guess I'm just scared of trying to open up communication with my parts because it's kinda scary that I even have them. The ones I have access to are traumatized and I feel them during especially bad episodes and sometimes it really affects my functioning and can put me in danger. Teaching them healthier ways to cope will probably help. I'll take baby steps, thank you

hippie_nerdy_gal

4.3y

IFS is really nice because it’s gentle to all parts of your system. It’s all about helping everyone feel safe and understanding their needs.

NotARobot0010

4.3y

CBT did not work for me either, so I feel you there. What has helped me is Emotion Focused Therapy and IFS (Internal Family Systems).

numb2day

4.3y

I did EMDR for a long time and it helped. You're right though you need to be ready for it and also the therapist needs to be good because it can be dangerous. People think healing is supposed to be hell and so they can allow themselves to be hurt without realizing it because they want to get better fast, which actually slows the healing process. IFS therapy seems to be helping me now. If you can find a good IFS therapist who also does EMDR that might be helpful, just in case you might be able to do EMDR later.

echidnalips

4.3y

I did CBT most of my life, never having received a cptsd diagnosis. It was useful for the depression and anxiety. But looking back at it, I feel like those therapists were overlooking the largest of all my illnesses. I don’t think it was something they did. I’ve been doing EMDR for a while with a new therapist. It’s painful and does throw a wrench in my “getting through life by disassociating” tactics, which does leave me less functional. But it has done wonders!!! But, I’ve heard you really have to be in a safe and stable state to do EMDR, and some people never get that. That’s when CBT was useful to me.

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