Wednesday 25 March 2020

Trauma Focused CBT: Session Ten

(TRIGGER WARNING: Covid-19, Mentions of abortion, trauma, domestic abuse, physical, psychological, and sexual abuse)

In the week leading up to this therapy appointment, a lot had happened in the news. Coronavirus became a pandemic, hundreds of people dying from the virus, places (like cafes, bars, cinemas etc) closing, people urged to stay at home unless needing supplies from the supermarket, and lockdown was looking very likely. It's a very worrying time for everyone, even without an anxiety disorder on top.

Amongst other things, I have Generalised Anxiety Disorder, Obsessive Compulsive Disorder, and Post Traumatic Stress Disorder. I have found these have all flared up in different ways. I worry about everything more, I'm doing my checking rituals more often, and I have these thoughts that I am unsafe and something really dangerous is about to happen to myself or my loved ones. As well as this, my flashbacks have increased.

I am coming to the end of Trauma Focused CBT for my traumatic abortion specifically. My therapist and I have come to realise that my abusive relationship with an ex brought up traumatic symptoms for me too, but this lot of therapy is nearly over so I'd have to re-refer myself or find some other therapy or counselling to help.

As for the traumatic abortion, I think my PTSD symptoms have lessened slightly (overall, I mean) but the physical pain etc from it still crops up as vivid flashbacks. I may need the odd couple of sessions to give me tools to work on my feelings about this, but I think I am coping well enough to deal with this trauma generally, and use the skills I have been taught for this.

My therapist and I did talk about the abusive relationship, and how memories of that affect me now. It was a long conversation with lots of questions about how my ex partner treated me, how I reacted, and how I feel about it now. I spoke about a few things he had said and done, that affected me badly. I know that I'm not coping well with it, I do get intrusive thoughts, flashbacks, bad dreams etc and I find it very hard to trust men who are interested in me.

This relationship started just as I'd had my abortion, and I believe I was looking for a fresh start, as well as someone to look after me and support me. (You can read more about my abusive relationship here, but I will mention a few things that he said and did.)

My ex partner was very nice and gentlemanly at first. He bought me flowers, took me to nice restaurants, said lovely things and didn't push me to do too much. This soon changed though. I thought he understood that my abortion had been very distressing for me and this is why I was so depressed and quiet. In later arguments, he would bring this up and tell me that I (and others) should've focused on how he was feeling and paid attention to him more.

I found that everything was ok, as long as I agreed with him and everything was on his terms. As soon as I didn't, or they weren't, he would be cold, callous, and cruel. He would push and push me to do things I didn't want to do. On one occasion in particular, he tricked/forced me into doing something sexual that I wasn't comfortable with. Straight after, he acted as if nothing was wrong. I was left feeling confused, violated, and as if I was overreacting.

He would use the old cliche "you'd do this if you really loved me".

As well as this, he was psychologically controlling, he gaslit me, and tried to keep me away from my friends. It was as if he wanted to control any situation we were in. It took me a while to realise that he was so toxic. I tried to break up with him at one point, and he wrote me a long letter to supposedly apologise and promise to change. I foolishly took him back and things had unfortunately not changed.

When we did finally break up, we would still argue, and at one point he followed me back to my student house to "talk". I didn't want to, but he wouldn't take no for an answer (a running theme in our relationship...). I tried to walk away from him, but he grabbed me hard. At this point, I was scared that he would hit me. I couldn't get away because his grip was too strong. It was only when my housemate walked by and saw, that he let me go and ran off. I was understandably really distressed and it took a while for me to calm down. 

I told my therapist about this (amongst other things that had occurred in our relationship) and she confirmed that my ex was very abusive and toxic. She also believed that although he made me feel vulnerable, I was actually very strong for arguing back despite my fears about the consequences.

She told me that although these sessions of CBT were for the abortion specifically, after a break I could get re-referred so we could focus on this abusive relationship. She did recommend I contacted Women's Aid though, as they are apparently very good at providing support to do with domestic abuse. I could even get some counselling from them.

After this telephone therapy session, I felt very uncomfortable, unsafe, and as if I was being violated all over again. The psychological control was personally very hard to cope with, but I seem to be most affected by the sexual abuse I experienced. I feel so uncomfortable in my own skin, as if I want to scrub it all away?

I have decided that once these therapy sessions are finished, I will take a month or two's break, then I will contact Women's Aid to see what they could offer. I guess any counselling will be done over the phone for now (because of Covid-19 restrictions).

In the meantime, I aim to use my time to distract myself with games, movies, cross stitch even. I also want to be very kind to myself and as supportive as I can be towards my friends and family.

Resources

Lockdown: https://en.wikipedia.org/wiki/Lockdown

Symptoms of PTSD- What are flashbacks?: https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/symptoms-of-ptsd/#WhatAreFlashbacks

Amys Mystery Illness- I'm a Survivor: https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html

11 Warning Signs of Gaslighting: https://www.psychologytoday.com/gb/blog/here-there-and-everywhere/201701/11-warning-signs-gaslighting

Women's Aid: https://www.womensaid.org.uk/




Wednesday 18 March 2020

Trauma Focused CBT: Session Nine

(TRIGGER WARNING: Abortion details, domestic abuse, sexual abuse, psychological abuse, mental health stigma)

"Double Trauma"

I'd been in quite a good mood; leading up to this latest session. At baseline, my moods have been stable and rarely very low. I'd even had some days where I could say I felt happy, or at least calm. I'd not reacted so severely to things that usually upset or anger me either. Generally, I think I'd been coping well.

I've been feeling that I'm coping with people's attitudes to abortion because I finally believe I made the right decision at the time. The thing I've been struggling most with is the physical side of things. The blood, tissue etc, distressed me because they were so graphic and result in such vivid flashbacks.

At this latest session, I explained all of this, and my therapist was pleased. She left it up to me to talk about what I wanted to, and the abortion appointments cropped up in conversation. She asked me some in depth questions, in order to gently expose me to my most feared memories. I coped, but I did get very worked up and shaky as I explained everything.

When asking about support from friends etc, my abusive ex partner came up in conversation. He appeared to be supportive and gentlemanly at first, but only when I was doing what he wanted/agreeing with him.

When things didn't go his way, he would be very cold and controlling. He made everything about him, rather than considering my feelings. He made digs in conversations and arguments. He also forced and tricked me into doing things he wanted sexually. I found that he expected me to do what he wanted because he was the virgin and I was experienced; so it was (in his eyes) my "duty" to teach him and let him experience new things with me.

I described a time he tricked me into doing something I didn't want to do, then carried on as if nothing had happened. I felt violated and confused. Did I let him? Was it my fault or his? Was this normal or abusive?

I got quite distressed when describing this relationship, and my therapist said it seems like being in the abusive relationship straight after the abortion made this a double trauma for me.

I thought about it a bit, then agreed. I thought I'd moved on from it, but it still affects me now and I'd buried it for a while.

Overall, I've been coping with my trauma from the abortion, but I have not really dealt with the trauma from the abusive relationship. I did feel I had to hide it from people for a while, in case I wasn't believed. My ex partner made sure lots of people thought I was "crazy" when we broke up. He called me many different names and turned people against me. Even when we broke up, he wanted to control some of my life.

The friends that stayed by my side were invaluable though. They defended me, and made sure I was ok. I thought I was at the time, but years on I realise how it has affected my trust in men especially. I feel scared to disagree or say I'm not comfortable doing certain things. Hopefully, in time, I will be able to be more assertive and be part of a more equal partnership.

Thankfully he's also halfway across the world from me now. I just wish I could move on from this, but I know it will take time.

I was hoping to finish my Trauma Focused CBT sessions very soon, but I think I will need a few more with a focus on this.

Friday 6 March 2020

I Decided to take a Social Media Break

As of last Monday, I decided to take a Social Media break.

I'd been scrolling on Facebook and Twitter particularly, and had noticed symptoms of my mental illnesses flaring up, as well as a general sheer drop in mood. The kinds of anxieties I had were about friends. I'd found that not many people were replying to me and some were replying in a more blunt way than usual. Naturally, I thought that they were finally getting fed up of me, and as much as I tried to believe that maybe they were having a bad day/week etc themselves, I couldn't help but place the blame on myself and criticise myself for "pushing them away".

The more I ruminated over this, the worse I felt. That, coupled with my worries over getting more ill and having no help from the Community Mental Health team, meant that I was heading towards crisis point. I broke down in my last CBT session and stayed that way for days afterwards. Eventually I decided I had the choice of either returning to a very dark scary place in my mind, where I actually am pushing everyone away and making dangerous decisions, or I could make a vow to change my mindset.

Of course, this is easier said than done, but I was at a point where I could "catch" myself before I went over the edge, At this point, choosing was difficult, but possible.

I decided that because the Community Mental Health Team wouldn't save me, I had to try and save myself. I started with a social media break. I needed to stop scrolling through my timelines; letting everything get to me and being bombarded with bad news and more people to "cancel".

I have taken social media breaks before, but usually this was with the ulterior motive of seeing if anyone noticed and would message me. I often feel like people would barely remember me if I was gone. I also worry no one sees me as close a friend as I see them.

The main reasons for this break were to have time in the "real world", take time for myself to reassess how I feel about friendship, reassurance, and myself. I need to become more self compassionate and self reliant especially.

Although I wasn't necessarily expecting messages, I did get some from a couple of friends. I've missed talking to people (barely anyone texts me these days), so getting some messages has helped.

I've also recently been reading a book called "The Compassionate Mind" by Paul Gilbert. I've been finding it very useful. I can relate to a lot of things in the book (my mindset, things I worry about, things I do etc) and it has a lot of exercises I can do. These exercises aim to conjure up self compassion and compassion for others. It involves a lot of meditative mindfulness tasks too.

Since reading this book, and completing some of the exercises, I have found I've had times where I feel peaceful. I still have a long way to go, but I am doing better than I was. I think I've managed to pull myself further away from a crisis; which is such a relief.

In case I do get to crisis point again, a friend helped me to plan what I could do. This would involve letting my parents know so they could get in touch with the GP who I find is most helpful for my mental health. He would possibly see me for an urgent appointment, and I would get advice and/or emergency medication (depending on what he felt was appropriate). Alongside this, I could also talk to trusted friends and ring my local mental health helpline. They may be able to advise me as to what to do, or help me calm down and think more clearly. The problem with being at crisis point is that you often don't feel in control of your thoughts, feelings, or actions. It can be a very risky time and it is important to have a plan that is easy to follow.

For now, thankfully, I'm not at that point though. I also don't feel as worried about friends who don't contact me much/at all. I know that the true friends will stick by my side and it is important to concentrate on them, as well as being reliant on myself.

I will continue to read the compassion book and complete the exercises every day. I seem to be using it as a guide, and maybe that is what I need right now. My next CBT session is on Monday, and I'm hoping I can give some positive news to my therapist then. I do not feel I made much progress in the last session, but I think I needed to get to that point in order for something to change within me.

So right now, I can't say I'm exactly happy, but I'm OK and I think I'm making slow but steady progress. My next blog post will be about my next Trauma Focused CBT session.