"How Do I Know I Have a Therapist Who Can Help Me?"

A woman is given our PTSD imagery before she is ready, becomes more distressed and symptomatic, but her therapist presses her to continue with it just the same ... Question:
Belleruth, I have PTSD from several years of working in a secure juvenile treatment center, leading up to one particularly violent episode which I think triggered full blown PTSD.

Invisible Heroes My therapist recommended your guided imagery CD and I am reading your book (taking notes in the margins because my concentration is shot).

The trouble is I can''t listen to the guided imagery. I made it through once, but I was so traumatized at having to go deep into my heart (I was fine with the barren wasteland, even comfortable there), that now I have panic attacks when I try to listen to the CD. I''m scared to death of it.

When I thought of my heart, it was like titanium, there wasn''t a core, no way to get in. I know you base your healing on imagery, but what if it''s too painful to do? Have you run into other people who can''t use the CD? Do they eventually use it? What can I do in the mean time?

I''m trying to journal and that seems to help, but I don''t know if that''s enough of a "right brain" activity to start healing me or not. How do I know that I''m not traumatizing myself worse, like the Frannie sessions you described in your book? I''ve made it through 4 therapy sessions and I seem to be getting worse. I really related to your paragraphs in the book on that. How do I know if I have a therapist that can help me?

Dear Sandra,
First of all, you should not force yourself to listen to the Healing Trauma CD if it''s upsetting you and making you feel panicky. So please set it aside for now. That''s our most high-test, super-intense imagery - very effective but very evocative - and although many people benefit from it immediately (especially long-term trauma survivors with pain that''s been seasoned by time) others need to lead up to it by starting with more neutral, skill-building, relaxation imagery and self-regulation tools, so they have a built-in mechanism for calming themselves down, quickly and easily, when their alarm reaction kicks in. And yes, this sometimes happens to other people when they’re not ready for it.

panic attacks panic attacks Actually, the Panic Attack imagery has what you need right now - some simple tools for self-calming and relaxation. It has three very simple methods for self-regulation, some non-threatening imagery for marshalling more of your courage, motivation and sense of self; and some affirmations that will also help. This is what you should be working with right now, as far as imagery is concerned... either this or the Stress Hardiness Optimization CD, which starts out with the same three self-soothing exercises, but offers different imagery - for relaxation and for help with sleep.

If your therapist is pressing you to talk about the traumatic events that led to your present state of mind, and is insisting that you keep listening to the trauma imagery, she''s pushing you too hard and in the wrong way, and that probably means she''s not very experienced at dealing with PTSD. You need to build up your self-regulation capacity first (the exercises on the Panic Attack CD will do this, as will the exercises on the Stress Hardiness Optimization CD).

Additionally, someone with skills in EMDR (Eye Movement Desensitization & Reprocessing), EFT (Emotional Freedom Technique), SE (Somatic Experiencing) or one of the other alphabet therapies listed and described in the book would be extremely helpful for you. These methods will help you reduce your symptoms without activating major distress in the way that talking about the traumatic events does. The combination of simple self-soothing imagery, plus an alphabet therapy, would be the ticket for you at this time. You need a referral to someone who is skilled at these methods, and who is experienced at dealing with PTSD.

If our blog were up, we could post this question and get suggestions and referrals from other people in your area. But it''s not quite ready, unfortunately. If you tell me where you live, I might have a name or two for you. Or you could ask your local Mental Health Association or NASW (National Association of Social Workers) or APA (American Psychological Association) which therapists know how to work with these methods.

I hope this helps. Please keep me informed on how you are doing. I''m sorry the trauma imagery contributed to your distress. But you can reverse this with the right set of tools.