The Therapy for PTSD
Submitted by Awen on Thu, 08/12/2010 - 12:31pmI just wanted to share that I talked to the SUNY New Paltz trauma psychology specialists (they are the big deal in PTSD stuff right now) and the only therapy proven to help PTSD symptoms are Cognitive Behavioral Therapies, which my great psychiatrist had also told me. They are: Exposure Therapy, such as EMDR; Cognitive Reprocessing Therapy which is where you write and read aloud the traumas to be exposed to it and also learn cognitive skills to challenge the beliefs that trauma has caused (I am bad, the world is unsafe totally, etc); and Stress Inoculation Training, which is what I think I am starting. That is where you learn about PTSD and the physiological changes it creates, then skills to stop them like relaxation stuff, and some cognitive skills like self talk and thought challenging, and then role playing and then doing these things and working on putting it all into action.
I did some CPT stuff on my own with the great workbook Ressurection After Rape, but I ended up hospitalized because I did it alone and a lot came up.
All the veteran groups are demanding this stuff because that psychodynamic talk talk talk stuff doesn't seem to be helping - and it takes way too long.
Hope this info helps people in the therapist search.
PS I know, the Icarus world is addictive and I must be in the real world, but I swear I think you guys are the only ones who understand what I deal with inside and with therapists....
yes this is really
yes this is really interesting and helpful information. Thanks for sharing!
Thanks, this is helpful. I
Thanks, this is helpful. I may ask my pdoc to refer me for some of this. I know, I can't talk about stuff like this with my "real world" friends either.
Insurance Companies are
Insurance Companies are super gung ho for CBT and DBT based therapies (DBT is considered a CBT therapy) because they are the only therapy that is proven to work. All that psychoanalysis and psychodynamic stuff - No study proves it helps. (Same with 12 step programs oddly.) I am totally against the wars the US is in, but it is in my benefit - Now everyone cares about PTSD! In 6 counties in the US, there are courts just for people with PTSD due to the veterans being nuts and violent - and WE can use them if WE get arrested in those counties too.Suddenly people care about PTSD. Ten years ago people thought you were weak for having PTSD - now that soldiers have it, it is unpatriotic to not care about trauma survivors. So a lot the VA stuff is all about PTSD treatment. And all anyone has found that helps is EMDR, CPT, SIT and DBT - all CBT therapies. DBT is just a skills set you can learn in two weeks at a hospital program or at a weekly DBT skills group. The other ones you do with a therapist one on one. But my psychiatrist told me that he'd never allow anyone to do trauma work without learning DBT first because trauma therapy tend to make you sicker and worse before you get better - and DBt can help you keep yourself safe, alive, and sane during that process. Think of DBT as the basic life skills coping stuff for intense emotions. Those skills help you to not shoot people or yourself when doing trauma work.
You can do DBT in a workbook - I have a light green one I think called the DBT workbook. But it is easier to learn in a class I think.
I think when the cops heard I had PTSD they thought maybe I had been in Iraq!
"When I tell the truth, it is not for the sake of convincing those who do not know it, but for the sake of defending those that do." -William Blake
I guess the trauma
I guess the trauma assessment I was up for at Mt Sinai might have lined me up for some of this stuff. I'm not sure. I went to the website re. the assessment programme and it was pretty vague about what the patients were to get out of it. It just said vaguely that some patients found the process of assessment helpful, through learning about yourself, but it didn't say it gave you access to therapies. I guess they would make recommendations for treatment back to my pdoc and then she would try to access the therapies? But it didn't say that...my pdoc was out of town so I made just a gut decision which clearly I am still trying to justify to myself. It was also a research study, which kind of got my back up, because nobody told me about that part until I got a long thing in the mail to sign. I could still be in the program and opt out of the research part, but I didn't really get it and there was no explanation. If I were to be in the research study, I would have to answer questions in front of a one way glass. How creepy. I was feeling pretty distrustful of pdoc's in general at the time, and nothing around this put my mind at ease so I just said no. Anyway, why can't my pdoc assess me herself and send me for this stuff? She already knows my history. Ugh. I guess this is me going round and round on the same point until I get over it. I feel really glad you are so pro-active and share all your info, so now I know what to look for and ask for.
Well, you know, even though
Well, you know, even though my psychiatrist knew what kind of therapies would help me, he couldn't reccomend anyone because most therapists are not trained in them. There are no cognitive processing therapists in my area. At bes you hope for some you trust and like who does DBT or/and CBT stuff. Don't beat yourself up. You don't know what that study would have given you or the accessment. If you have a diagnosis of PTSD then they already know what treatements are proven to work. It ends up back in your hands to make a million calls to therapists and ask if they are trained in DBT or CBT and ask how they work with trauma. I have found that the ones here where I moved to are very angry when I say what I am seeking, but screw them. If they do EMDR or CBT or DBT, they are a good start. But the main thing everyone says is that you have to trust them - If you feel unsafe with them, it doesn't matter what skills they have for you.
I hate having to be proactive but waiting for someone to help me hasn't gotten me anywhere. It's my life and even though I hate this fact, I am the only one who cares enough about it to get me the right help....
"When I tell the truth, it is not for the sake of convincing those who do not know it, but for the sake of defending those that do." -William Blake
The information you've
The information you've shared here has really helped me. I don't even know if I have a diagnosis, my pdoc just mentioned it a number of times and it seems to fit. What you said sounds like good advice, I'll stop mulling over choices I've made in the past.
I'm kind of realizing Toronto is a pretty great place to live for access to stuff. I don't know about other cities. I spent half an hour searching DBT and found someone five minutes from my house! As well, the expressive arts therapist I found is right near by. I don't know about free services. I wont do groups. It is triggering and feels a little like assembly-line therapy. I don't want to be on a waiting list for months and then not even like the person when my turn comes. I realize not everyone can afford to pay for stuff, and actually I barely can, but I think when i pay for stuff it gives me an added sense of control, and makes me more discerning, like it has to be just right or why am I going to be stretching my budget to pay for it. I think on some level when OHIP hands me something I don't look at it the same way. It is free so I don't assess whether it is what I really want and need. These are just my thoughts for the moment. Also, I'm pretty resentful and mistrustful of my pdoc right now, hopefully I will be able to change that when she gets back into town and we have a discussion of some kind. Still not sure how to proceed with that.
OMG I totally understand you
OMG I totally understand you - When I get free services I feel like I have to just accept shit with a smile, but if I pay then I have hired them. I went to the free mental health place here and the woman actually said she was nice enough to take time from her busy schedule to see me and I said "Wait. This is your paid job. You are not doing me a personal favor. So now, what were you saying?" and she looked realy shocked. They are so used to people just allowing themselves to shit on.
Toronto has a hospital with a trauma recovery program - art therapy, movement therapy, DBT, CBT - everything, and i think it is OHIP covered and i think it is no groups. Not the Clark either.
"When I tell the truth, it is not for the sake of convincing those who do not know it, but for the sake of defending those that do." -William Blake
I like the way you handled
I like the way you handled that, I'll have to remember that. I wonder if the program you are mentioning was with women's college hospital. Because Milada, who is the art therapist who I've seen a couple times, said previously she ran an art therapy program for (trauma?Rape?) survivors at women's college hospital and then the program was cut. My lead re DBT has come to a dead end. He sees clients only afternoons and evenings, when I am working myself. If I take time off work to see him, then I have to add the lost hours to the cost and it becomes too costly, even assuming I would be able to arrange this. I was initially disappointed, but then I reflected that his e-mails seemed cold. I know this may seem like an irrational judgement, but when I contacted Milada she was able to convey warmth and interest through her e-mails, and that put me at ease. Maybe this is a skill not everybody has, but it counted for something with me. Unless some other opportunity comes my way, I'm going to stick with seeing Milada for a bit and see how that goes. The last few days I have been feeling vulnerable and less strong. I think it's not the time for me to be shopping around. I also remember what you said at some point about trust, and liking the person. I do have a good sense about Milada, which maybe is more crucial right now than what techniques she's trained in. When I was feeling stronger, I felt happy with the idea of seeing her, and only now that I am feeling less strong I am second guessing my choice, because self-doubt rules me at times, so I think I need to remind myself of that. She also is not exclusively an art therapist, she is a psychotherapist, so I think she may be able to work with me in a number of ways.
I was in the Clark for 3 months so I don't think I could ever be involved in a program there without remembering those dark days.
I hope your quest for the therapy you need is going to be fruitful this week.
(It just occured to me too, if down the road I want to find DBT, Milada may have some leads...)