Trauma-safe(r) therapy resources?

So, of course, everyone's issues with that are different, so if anyone else has different mental health and trauma problems from mine that interact in a different way with therapy, you're welcome to also ask about it here.

At the moment, I've been trying to look into DBT. The problem with that, aside from executive dysfunction (I have extremely low spoons and am currently trying to spend them on stuff like not forgetting to apply for college for next year), is mainly trauma-related. First of all, I just don't feel safe around therapists at all and am hypersensitive to what pings me as manipulation tactics (and DBT is just full of those), and secondly, I ended up with dissociation issues - which, if people such as these are to be believed, is contraindicative for traditional mindfulness exercises. This is also the case for psychosis and paranoia, both of which I've had issues with in the past.
So basically, what I'm asking here is: since everyone seems to agree this is what I need to do, and cherry-picking safe practices from it would be bad, what is the best way to either avoid these issues or get over them quickly enough?

 

Bump?

 

Other bump that could hopefully get approved early enough to be in the new posts sidebar thing?

 

So, I can only speak for myself, but—I don’t think that I could ever answer this question for you, because I’m not a trained therapist or psychiatrist, and even if I were, I’ve never treated you as a patient. So I’m not able to do anything other than guess, yknow? And in the past, you’ve seemed dismissive or upset by people’s guesses, because they don’t seem like they’ll help. I think a similar thing might happen here, because in my (pretty extensive) experience as a patient in the US mental health system, in in-patient, out-patient, and regular therapy contexts, DBT is the go-to trauma sensitive therapy option. Individual people practice DBT differently, of course. But the issues that DBT is designed to help with are often very tightly tied to trauma, and the treatment reflects that in my opinion.

 

Yeah, sorry for being angry about the people avoiding this thread, it's probably a reasonable reaction to have.

My problem is specifically that I've got trauma around therapy in general, and that the last several times I tried DBT, it was made pretty much impossible by that. Not only that, but there are elements of it which make me uncomfortable anyway, notably the aspects that feel kinda cultish, what with the way you're supposed to dedicate most of your day to mindfulness stuff and how it just feels like it's intended to make you think a specific way about everything, even if not directly related to emotional regulation.

This is nothing new, it's what I say every single time someone asks me why I don't do DBT. What is new is that I'm pretty sure since I've identified the problem, there have to be ways around it, and that is precisely what I'm asking for in this thread.

 

No experience with DBT here, but my uninformed suspicion is that Step 1 would probably be to tell the therapist about your history with and concerns about it, and exactly what you react badly to. Getting your therapist on board from the start about what you're worried about, what you want, and why is almost certainly going to be more effective than trying to strategize in advance about what kind of therapy to ask for, and make it easier to say no if they cross a line you don't want them to cross. Plus, if you're worried about getting a bad therapist, it might be a good acid test: if they seem at all condescending or dismissive, you can say "I don't think this is going to work out" and look for a different one.

 

Well, one of the issues I have is that due to my current living situation, I can't access in-person professional therapy - aside from psychoanalysis, that is, but that isn't really that useful at all. That's likely to change by the end of this year, which is great, but in the mean time I'm trying to figure out how to handle things with other resources, either self-help or online therapy.
... Actually, I guess I should have mentioned that in the first post, because that sounds pretty important to know.

 

I’ve been using DBT and CBT practices for anxiety, paranoia, and “possible” bpd, and Am Willing to maybe try and walk through the steps my therapist has suggested to me. The DBT I used for anxiety spikes (I couldn’t take anxiety meds because it was a glorified blood pressure pill and made it unsafe to work since im in a kitchen with knives on the daily)

I’m on my way home, but if you’re willing I can give you resources/guides on both that are as non-intrusive as possible.

 

That would definitely be very helpful! My limited experience with CBT has been generally positive, though it all predated the bulk of the psychiatric abuse I've been through and I unfortunately can't access it professionally anymore.

 

Two phone apps that are helpful:

• PTSD Coach by the US Department of Veterans Affairs (this is the apple app store page but there is an android version)
• Mindfulness Coach by the US Department of Veterans Affairs (similar app, apple app store but there is an android version)

If you can't download those on your phone, download Bluestacks on your PC and get them there.
Actually, I encourage to get the apps on your phone and pc both if you're able.

PTSD and Mindfulness Coach both offer a well of techniques and applications that are primarily meant for people with PTSD or other traumatizing issues but can very easily translate to something simpler. I didn't use the apps much but from what I remember you can either answer a short question (along the lines of "What are you having trouble with" with some possible answers being "I can't sleep", "I'm anxious", "I feel angry", etc.)

You can also skip that and just grab specific tools from the apps, including meditations, white noise, and other things.

They also happen to all be DBT exercises.

DBT basically is just going "Hey look at THIS" and directing your attention (and emotion) elsewhere. When you start to feel upset or anxious or paranoid or WHATEVER, try to just. Direct the emotion somewhere else. Practice outside of your stressful moments so you get a feel for what's "best" for you. DBT is for an In-The-Moment situation, when you begin to feel yourself getting upset.

Some DBT exercises:

• Imagining yourself in a calming environment. Visualize yourself on a beach, walking barefoot, feeling the sand between your toes and the water lapping at your ankles, etc.
  • It doesn't have to be a beach. Atmospheric sounds help. PTSD coach has a section for this specifically and has a variety of scenes to imagine.
• Immerse yourself in your environment. If you're eating something, mentally describe that food. How does it feel in your hands? What does it look like, are there any defects? When you eat it, are you biting into it or putting it in your mouth whole? What does it smell like? How does it feel on your tongue? What is the flavor?
  • Again, does not have to be food. You could switch to doing a chore, and mentally describe that, ex. folding laundry. The feel of the fabric, the scent of clean (or dirty) clothes, etc. Try to not describe as "This is a shirt" and instead try to pick out colors, shape, texture, etc.
• Deep breathing. It helps to have an app for this so you can measure your breath. They have gifs and little tools online, you don't necessarily have to download something for this one.
  • Eventually you could be able to do this without a visual guide of when to breathe in and out if you stick with this one long enough.
• White noise machine. I have an app on my phone for sleep aid called White Noise Deep Sleep Sounds, which even though I have the free version it gives me a lot of options. My personal favorite for sleeping is mixing Brown Noise (a calmer pure white noise variant) with "Airplane Cabin", but if you want to couple this with meditation (point 1), there's a variety of free ambiance noises to pick from including frogs, distant thunder, and rain on a tent.

Those were the ones suggested to me based on anxiety and paranoia spikes (on a scale of 1-10 my average operation is at a 4-5 and spikes are at an 8-9, most people operate at a 1-2 and have spikes of 4-6).

CBT is more about working through a problem by:

• Describe the situation.
• Describe your belief of the situation (initial thought)
• Pick out the Negative Thinking Pattern(s) (NPT)
• What is the evidence of this pattern existing in your initial thought?
• Alternative Thinking, or now that you've isolated the NPTs, what is your opinion of the situation now?

The four most common Negative Thinking Patterns are:

• All-or-Nothing Thinking: “I have to do things perfectly, and anything less is a failure.”
• Catastrophizing: “If something is going to happen, it’ll probably be the worst-case scenario.”
• Negative Self-Labeling: “I’m a failure. If people knew the real me, they wouldn’t like me. I am flawed.”
• Focusing on the Negatives: “Nothing goes my way. It feels like one disappointment after another.”

But there is also:

• Excessive Need for Approval: “I can only be happy if people like me. If someone is upset, it’s probably my fault.”
• Mind Reading: “I can tell people don’t like me because of the way they behave.”
• Should Statements: “People should be fair, and when they are not fair they should be punished.”
• Disqualifying the Present: “I’ll relax later. But first I have to rush to finish this.”
• Dwelling on the Past: "If I dwell on why I'm unhappy and what went wrong, maybe I’ll feel better."
• Pessimism: "Life is a struggle. I don't think we are meant to be happy. I don't trust people who are happy. If something good happens in my life, I usually have to pay for it with something bad."

My therapist actually had me not only write these out, but give a percentage of how much I believed my Initial Thought. So, for example, I believed in my initial thought by 80%, and after I wrote what NTP were present in the thought and my alternative thinking, I now believed in the initial thought by 40% or something. I'm throwing random percentages out, but it's an example.

CBT is for after a situation has happened and you're in a more rational state of mind to work through it.