Therapy

I had my first therapy nightmare!

Let's start at the beginning, shall we? Some of the basics I've learned in therapy. PTSD has 3 key diagnostic categories: Intrusion, avoidance, and hyper-vigilance. There are other areas of importance - obviously having suffered a trauma is one - but you have to have significant symptoms in those 3 areas to be properly, officially diagnosed.

Intrusion: These are the things that throw you back into the trauma in the course of your every day life. Flashbacks, nightmares, physical or emotional reactions to triggers. Some of my triggers that I've uncovered: People who look similar to my abuser, the Big Bang Theory theme song (long story), a certain house, condescension, and phone calls. For real, do NOT call me unless absolutely essential. For damn sure leave a message about why you called if you don't get me because I will have a panic attack.

Avoidance: Pretty obvious, this means avoiding triggers, distracting yourself from memories or physical reminders such as photos. This is actually a potentially healthy way of coping if you can avoid taking it to extreme levels. Ex: texting over calling can be a hassle at times, but it's still less disruptive than a panic attack, right? A version of this is actually a skill I'm working on with my therapist. The problem comes when I avoid significant things, like important conversations because I'm scared of confrontation or paying certain bills because they are tied to his financial abuse and therefore might trigger me.

Hyper-vigilance: This feels a lot like a panic attack. All my senses get cranked to 11 when I'm triggered and I look for signs of danger everywhere. My therapist mentioned that if you can learn to exercise conscious control over this symptom, it can actually become a useful tool. But when triggered unexpectedly it overloads my system and I shut down (dissociation).

So since my trauma includes assault, I was/am an at-risk person for re-traumatization due to labor and delivery. I feel reasonably confident that childbirth did worsen my symptoms as I had what many would consider a perfect delivery but I still hate thinking about it and avoid doing so. Probably didn't help that I wasn't given time to myself afterward as I requested. That will go differently next time, I promise you (and myself) that much. Plus the hormone dump and changes were bound to exacerbate the crap that I've had hanging around for years now.

Depression and anxiety are typical parts of PTSD (and PPD for that matter) to the point that they are basically diagnostic criteria on their own. My therapist said that depression is a focus on the past while anxiety is a focus on the future. So the way to address them is to be in present. That makes a lot of sense to me, though we'll see if it helps. In short, there are 3 possible ways to get myself out of a bad spot when I find myself in one:

1. Safe space: a visualization technique where I craft and practice existing in a space that brings me peace and comfort. I'm not sure I'm comfortable sharing the specifics of my safe space yet, largely because I am alone in it. That could be because I genuinely desire and seek solitude or because I have trouble connecting to others and taking comfort from them. While I, like anyone, certainly do crave time to myself, I believe I fall into the second category. I don't trust people enough to open up to them as my weaknesses have too often been thrown back in my face.

2. Grounding: this is the part where I focus on the present. I assess my senses; what is going on around me? What do I see, hear, smell? Am I hungry, tired, thirsty? I focus on the current and the concrete. I've tried it a little and didn't find it especially helpful. Yet.

3. Meditative breathing: I'm a big believer in meditation. It's been scientifically proven to provide health benefits. Plus, I am bit of a sucker for yoga which is often meditative. I actually use that anxiety gif to slow my breathing at work, and it does help in the short term.

The idea is that we will use these techniques to help me cope with talking about my trauma. If I can tell my narrative, it should help me move on. But bringing all that stuff up is risky and can cause side-effects, so I have these techniques to use as needed. I've already told a large chunk of the story on this very blog, and apparently it didn't help, so we'll see how this goes. Herein comes the nightmare in which I was trapped in a version of The Walking Dead with my ex and literally ran out to be eaten to get away. (My dog saved me so... happy ending?) I could not move my body for about 10 minutes after waking and tried to use grounding to help me overcome the visceral feel that my abuser was standing behind me.

Theoretically, after we tell my "trauma narrative" and I get a good handle on my coping techniques, a lot of the depression and anxiety symptoms should fade. We will deal with what's left. Here's why I call bullshit. If you've ever taken one of these mental health questionnaires, you are familiar with the fact that they specify what symptoms you've experienced in the past week. I don't know about you, but if I'm in a decent enough place that I'm able to ask for help I haven't had a particularly bad week. So if I answer honestly, things don't look so bad. But if we were surveying the previous month, they'd be a lot worse. One of the darkest times of my life was several years after the wreck trauma (no PTSD there because I don't remember it) and several years before the abuse related trauma. I mean, we'll see. Maybe I'm totally wrong. I don't have great self-awareness.

I'm not feeling great, but I do feel a little more positive in the sense that at least I'm working on it. So far I like therapy. If nothing else, it's nice to dump all my fears and neuroses on someone else without feeling guilty for talking about myself.