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Re: Long term CBT***csa trigger » Daisym

Posted by antigua3 on July 31, 2008, at 8:29:30

In reply to Re: Long term CBT***csa trigger » antigua3, posted by Daisym on July 31, 2008, at 2:25:28

Oh Daisy, you always ask the really hard questions. It's so easy for me to think and believe that I'm right in what I'm doing that I often can't see the forest for the trees.
>
> My first question is what are you looking for, connected to long-term CBT? Do you want to make sure you are doing it right...or that your pdoc is doing it right? When I begin to research I typically figure out much later that I'm looking for 1) a short cut or 2) to understand the rules of whatever "tricks" my therapist might try to use on me.

>>I researched it because I wanted to understand what he was trying to do and why we were having a problem connecting--not to influence the outcome by being some know-it-all, trying to trip him up on not doing it "right," but I wanted a genuine understanding of how the process works. Since I've done this, we've had two powerful sessions.

From what I've read, and discussed with my pdoc, through this process, you first look at the feeling (anxiety), what lies beneath it (fear) and then figure out why I feel the fear--what am I afraid of? There's terror underlying the fear that I'm never able to access. It just cycles from anxiety, to fear, to terror, and then I change my circumstances (move around, do some work, etc.), which distracts me for a bit until the anxiety returns and the cycle starts all over again. I want to break that cycle; I have to break that cycle if I'm to truly get over this. Nothing to date has come close to letting the terror out, and that includes psychodynamic, hypnosis and EMDR therapies. I may never get there, but this is worth a shot.

I see the CBT as a methodical way to approach this. I am a very methodical/literal person and having an explicit process may be helpful.

> As far as the research on csa goes, "straight" CBT is not the therapy of choice, but a type of CBT called "exposure therapy" has lots of clinical evidence that it works.

>>Yes, I know exposure therapy is a therapy of choice for PTSD in this day and age of managed care, and I've discussed it w/my pdoc, but we aren't going to keep exposing me to the trauma to alleviate my symptoms. That would be retraumatizing me too much, he says; instead, think of it as concentric circles. We all live in different circles that start from our inner core to our outside life. We will work on each one of those circles, and I will tell him as much as I remember about living within each one--my inner circle, my family, extended family, school life, etc. At each circle, we will discuss my thoughts, feelings and actions, and see where that gets us.

In many ways, it feels similar to psychodynamic, but he asks different types of questions. It's upsetting, don't get me wrong, but it helps me to think in a different way.

>....for most people, changing their thoughts doesn't help them integrate their trauma or learn how to live with it. If you haven't read Babette Rothschild,'s "The Body Remembers" I'd recommend it.
>
>>I will read the book, thank you. There is some research that suggests that through therapy we can actually change neural pathways in the brain, to form a "corrective" experience. I do know that once I'm aware of a connection between my past and current life, the new way of thinking will finally take over after I've learned to practice that way of thinking. Whether or not it can work in this instance is still an unknown.

> I think I know what you mean about the distorted beliefs left behind. But I think the challenge is not to necessarily figure out what is "true" or "real" or "correct" - but instead to be able to hold two truths at the same time. Yes, you loved him. There were likely good reasons for that. My dad was my primary caretaker for the first 5 years of my life. So he hurt me but he also made a deep connection to me. And to this day, he says the most outrageous things but that doesn't negate the fact that he did call, that he loves me and he worries -- all very dad things to do.
>
> And yet, I know, very deeply, that he also destroyed me - or a potential me. So I imagine you love your dad and hate him. It is really hard to let the hate part out. We want to say, "I hate what he did but not him" etc. And maybe you don't. Only very recently can I say those words - but boy do they echo "this is a large sin" when I do. That's not to say that you might not be distorted - there might be more to hate than love when you look at all the facts dispassionately. Maybe your dad was a really bad guy. But that doesn't change how you feel.
>
>>Yes, my father was a really bad guy. Honestly and truly, no one in this world loved him except for his mother and me, and his third wife, who knew a different man. And faced with the evidence, there is no reason I should have this disproportionate amount of love. I can hold the good feelings about him--on a rational level I had good reason to love him--but I let the love overwhelm the situation, which is pathological, not just a matter of holding both feelings at the same time. But I will admit that hating him is very difficult, and in this case I don't believe in "hate the sin, love the sinner." It doesn't fit.

I'm pretty sure this is about letting the hate out and acknowledging what he did to me, the severity of it, and how it determined the course of my life. There is grieving going on for what I lost, and some of the sadness is seeping out, and I'm grateful for both of this.

> Timing - as they say. It might be equally helpful to acknowledge why you loved him and what you hoped for, as much as it would to try and force reality into your brain and heart. I just don't think that will work - the conflict is too deep.
>
>>I don't know about that. I'll have to think about this.

> For me - the conflict remains in the realm of "why?" Why did he do this? What drove him? As I've started to let go (some) of the "it was my fault, I turned him into a monster" beliefs, I've noticed another question looming large - "could I have saved him? Could I have turned the monster back into the dad I loved?" These are questions that are painful to grapple with and come from the youngest, most scared parts of me. The adult can think about them rationally and answer all the questions and explain all the feelings and draw all the connections. But the child is frightened and confused - and has a lot of plain old grieving to do.

>>yes, that may be a big part of it. But for me, the child has to grow up, and helping her to grow up in a much healthier way is my primary task.

Also, I'm not concerned with the "why" part. I think I've figured that out. There are facets of his own life that made him the way he was and I accept that. But that in no way lets him off the hook. I'm sorry you're struggling w/this, I know how hard it can be. It has been suggested to me on more than one occasion that I jumped over the anger and went straight to forgiveness, which may explain part of my problem.

I think there are two root issues:
1)There is a "reality" to this situation (of what type of person he was, what happened, etc.) and my interpretation of that reality.

2)While I argue that I don't blame myself for what he did, that may be entirely untrue below the surface. I don't believe I caused him to do the things he did, or wanted him to do them. They happened for whatever reasons that had to w/him and not me. I just happened to be there. I accept now that it wasn't because I was special or that he loved me more, etc.

Enough; sorry to be so long.
[antigua]


 

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