Wednesday 26 February 2020

Trauma Focused CBT: Session Eight

(TRIGGER WARNING: Mentions of abortion, self harm, and details of attempted suicide)

I felt very on edge, leading up to this latest appointment. I think it was for various reasons. Firstly, I was waiting on results of some scans and a possible follow up appointment with my Rheumatologist. Secondly, it'd been a while since my previous session, and I felt I hadn't done enough homework in that time. Thirdly, I'd been very down recently and felt I'd lost some of the progress I'd made with my PTSD. There were probably other reasons too, but the above states the main ones.

As expected, I scored highly on the Anxiety, Depression etc questionnaires. My moods had affected my behaviours and functioning, and they weren't helping my ability to keep myself occupied and maintain relationships either. I felt disappointed in myself and as if I'd failed my therapist. She asked me how things had been recently and if anything had happened in particular.

I explained that I had been very low and anxious recently, about various things including friendship. I felt very alone and distant from people I loved. I'd been very quiet recently and have felt that even when I have interacted with friends etc, I'd been saying all the wrong things.

My therapist wanted me to see how my moods were linked to the trauma from the abortion. I told her how I'd spoken to a friend who'd helped me through the abortion, and one who had an abortion herself a while back.

The main topic, surrounding my abortion, that I spoke about with the first friend. were the attitudes experienced from the nurses involved in my care, as well as the man who would've been the father of my child, and the new boyfriend I had at the time. I felt I'd had very little support from them, and judgement more than anything. The nurses judged my resulting in becoming pregnant, and my decision to have the abortion. The father-to-be also judged my decision to have the abortion, and treated it as a tragic loss (even lighting a candle to "mourn" when we were speaking via video call online). The new boyfriend judged my sexual history as well as my becoming pregnant, although he was all for me having an abortion (I don't think he wanted children).

When we spoke about the father-to-be, we discussed what might've happened had I carried on the pregnancy. My friend believed that he probably wouldn't have stuck by me, especially going by our on/off relationship. He seemed to find any excuse to dump me to be honest. The more I think about him, and our relationship, the more I realise that maybe he wasn't the right man for me after all. I think part of me never really got over him, and even saw the pregnancy as a bond between us (even after it was over). I feel I have moved on from him, if not the trauma however.

The friend I spoke to, who had experienced an abortion too, had similar judgement from the nurses involved in her care. In time, and with a lot of therapy, she had managed to move on as much as possible, and did not find memories of this traumatic anymore. I found it eye opening that the nurses had been just as unprofessional towards her, and I felt angry and upset for her. To know that she could move past this gave me hope though. Maybe I could do this too, in time?

We spoke about how I hadn't gone into much detail about the abortion, and that I find it hard to face. I'm still avoiding a fair amount of things, including carrying on conversations about abortions, reading views on them etc. I explained that I was scared of being badly triggered and becoming very unwell again as I felt I wouldn't be able to get any help.

I then talked about how my thoughts still go to self harm/suicide when I find myself in a situation I cannot/easily get out of. She asked if I remembered a time in the past when that happened. We spoke about a time I was threatened with sanction on the Work Programme (Part of Work Related Activity for Employment and Support Allowance), for a situation I could not help. Basically, at that time I was too anxious to travel places on my own. My dad worked shifts at that time, and his shift patterns changed so that he would not be able to take me to appointments with the Work Programme. No one else I trusted could take me, so I suggested having telephone appointments, but was refused. Being in this catch-22 situation, worrying about loss of income, I became so suicidal I nearly ran into traffic.

I got very upset in this therapy session, as I explained how scared I am of going back to that point.

She asked what would happen if I got to that point. I explained about my experiences with CMHT assessing then discharging me because I'd already had help from them in the past, and they felt there was nothing more they could do. I also told her what the A&E Psych Liaison team had said (They described me as a square peg, and the CMHT as a round hole. This implied that I was simply too different to be helped by them) and that I felt the door was permanently shut to me even though I couldn't understand why I should be any different to anyone else when I need that sort of help.

The session came to an end soon after this, once I had calmed down. My therapist gave me homework to be kinder to myself, read bits of the self compassion book she had recommended (I can't remember the exact name, but it is by Paul Gilbert) and try to talk to friends more directly.

I still feel affected by this session, but having a good cry and venting my fears has helped. I know that I need to make a change, for the sake of myself and my loved ones. I need to be much kinder to myself; practising self acceptance and forgiveness.

Thursday 6 February 2020

Trauma Focused CBT: Session Seven

(Trigger Warning: Mentions of Abortion, Stillbirth, and Miscarriage)

I felt quite down leading up to, and during session seven. My homework was to pick some of the feared situations from the list I'd made in my last session . I decided I would try to look at some pregnancy scans on Facebook, as well as watch some story lines on television, of stillbirth and miscarriage. I was also to carry on using the term "Abortion" rather than "Termination". As well as this, I was to keep on journalling and noting down how putting myself in these situations made me feel and how I coped with that.

I find using the term "abortion" isn't so fearful now. My feelings about the term are more the way someone would react when a word makes them cringe (e.g. "moist"). For the record, this does not mean I am against abortion, it's just that the traumatic one I had makes certain things affect me in different ways. So saying the word brings me back to that time, but not so intensely that I panic and get particularly triggered.

I can also cope better with seeing pregnancy scans. Before I exposed myself therapeutically to this, I found being faced with any pregnancy scan triggered me and would bring back flashbacks of being told I'm pregnant and feeling scared about what was to come next. I can separate other people's scans from my own now, and am not brought back to that time so uncontrollably.

Watching story lines about any kind of baby/fetal loss is still very difficult though. I'm forcing myself to stop avoiding these story lines, or zoning out (although I do still find myself dissociating sometimes). Stillbirth isn't as triggering, although it upsets me as much as it would upset anyone, if not slightly more. The physical side of miscarriage and the attitudes towards abortion that you see on medical dramas for example can be very triggering however. It can trigger flashbacks of the most graphic parts of my traumatic abortion; including the sickness and pain. The attitudes also remind me of the judgmental attitudes of some of the nurses I saw at that time. I was made to feel like an irresponsible teenager. I was also made to feel guilty by the potential father (he lit a candle to "mourn our loss") and made to feel like a burden by my partner at the time, in subsequent arguments around this subject.

I explained all of this at my latest session, and my therapist helped me to understand that although I had made the decision to have the abortion, the attitudes of those around me and the physical pain etc was not my fault. I had made the right decision for me at the time, even if I thought I may have coped if I'd kept the baby. It still would've affected a lot of my life.

My next piece of homework was to go through more feared situations. This time, I decided to try and talk to the best friend who supported me throughout, about my abortion. I also decided, if appropriate and carefully planned, to talk to a friend of mine who has also had an abortion. This would hopefully help open me up to other perspectives, their views on what I/they went through, and importantly, to feel less alone and more connected with people who have been through similar.

So far I have managed a short talk with the best friend; where we mainly spoke about the attitudes of people around me at the time. I found this very helpful, validating, and eye-opening. I won't go into much detail but we discussed the potential father and how flaky he could be when it came to supporting me. I hadn't fully realised this at the time, but I know now that it was true. I was so in love with him, but I'm glad to have moved on. I don't know what the future will bring, but I do hope I find the right partner for me, who would like to have children too. I also hope it is not too late to have children by the time I am ready.


Amys Mystery Illness - Trauma Focused CBT: Session Six: