PTSD, CBT

[Moon bunny]

Apologies for abbreviations in the title, but if you know anything about them you will know the abbreviations.
Basically I escaped from an abusive parent some years ago, and came to England only to find myself in the clutches of an abusive partner, (university educated, good job in a large organisation, liked to push women into walls if he had a bad day at work.)
Well I got away from him, then some months later the nightmares started, then anxiety and flashbacks so I went to the doc who fixed me up with the county mental health team. I was prescribed Mirtazapine as a quick fix, and CBT for the longer term.
The trouble is I am sure CBT is making things worse, I am snappy and sarcastic now, which I was not before CBT started, I am also hypervigilant to an absurd level, I cannot go into a supermarket if it is busy, walking cycling* along a busy street leaves me drained from checking everyone for signs they might attack. A friend saw me returning cycling* home from CBT this morning and seemed very concerned about how tired I look.
So, 4 weeks into the CBT course is this normal? Do things get worse before they improve?


* I told you it makes me sarcastic.

 

[Paul99]

So, 4 weeks into the CBT course is this normal? Do things get worse before they improve?

I haven't had CBT but both my partner and her brother have, and it took a fair few weeks longer than 4 before they found any benefit. It may be that the symptoms you are having are as a result of the PTSD rather than the CBT. Could it also be a side effect of the Mirtazapine? I'd certainly mention it to your GP and/or the county mht, they will be able to give you better advice.

All the best, and if you feel like you need to post on here, go right ahead.

 

[Andrew_Culture]

By doing research and using the online course at http://www.llttf.com/ and by reading this page several pages a day I sort of made my own CBT course. It took a while to sink in and you really do have to stick with it, but for me it pretty much turned my life around. But my mum has done led CBT classes and didn't find them as useful. I say it helped me, but it wasn't easy. I also tried mindfulness but that appears to exacerbate matters.

 

[coffeejo]

I found that CBT treated the symptoms, not the cause. It helped reduce the frequency and severity of the flashbacks I was experiencing due to PTSD, but did nothing for the root issues. I'm now doing Art Therapy and am finding it much more helpful in that respect. I've also been on Mirtazapine (twice) and asked to come off it each time as it didn't suit me - apart from the increase in appetite, which made me unhappy, I was also experiencing extremely vivid dreams that screwed with my head.

But yes, in answer to your question, it does get worse before it gets better, whatever therapy you're doing. The often-used analogy is that of a burns victim - in order for the new scar tissue to develop, the dead skin needs to be removed. And that hurts.

 

[craigwend]

Discuss this with your therapist first ...

The PTSD, booklet may be useful at a very basic level http://www.ntw.nhs.uk/pic/selfhelp

 

[Little My]

Dear Moon bunny, I'm sorry to hear that you suffered a long term abuse. I admire your resilience and wish you all the best with your recovery.

It's not so much that CBT is making things worse, but that it may makes you more aware of the symptoms (being hypervigilant, etc). Your therapist should make it clear to you from the start that expect improvement after 4 weeks of treatment is a bit unrealistic, considering how long you were suffering (you barely had the time to get to know your therapist/trust him or her and you probably just starting to scratch the surface). Yes, often things get worse before they improve, as to heal you need to get in touch with some painful and difficult aspects of your past experiences.

You don't need to answer that, but how long is your 'longer term'? (anything below 20 weeks is a short term work). Also CBT is often concentrated on the reduction of symptoms and the therapists are under pressure to get their patients to improve and off the books, so there often isn't time to address the underlying stuff. You need to speak to whomever you see to ask what can you realistically expect, what you are you hoping to achieve and what other options are available to you. Maybe CBT is not the right modality for you, but it's difficult to say without knowing the particulars.You might need to stay in therapy for a longer term, so it might be worth exploring what is on offer by your local mental health services or could you be referred to any charities providing long term low cost counselling.

I can also recommend an excellent book on the subject - 'Trauma' by Gordon Turnbull.
http://www.amazon.co.uk/s/ref=nb_sb_noss_2?url=search-alias=aps&field-keywords=gordon turnbull