To be beyond frustrated my MH trust told me I’m too complex?

You sound similar to me in so far as I am in my fifties and have had CPTSD from childhood due to it being scary, chaotic, abusive and terrifying.

I'm getting schema therapy on the NHS which sounds really good for me. It's about changing maladaptive coping mechanisms and being reparented.

Can I ask what type of therapy you got?

Also what do you mean by 'an episode' and what help do you get when it happens. Hope it's not too intrusive to ask that?

Speaking of neuro divergence.

It is more common than you think for people with neuro divergence to struggle with making phonecalls and speaking on the phone. Particularly autism and this is recognised.

People who are neuro divergence have much higher rates of mental health problems.

So a trust having a service where they will only do initial assessments by phone is discriminatory and absolutely insane as it means a key group can't access services.

The fact that mental health services don't recognise this cross over is appalling.

Problem is early trauma and neurodivergent have massive crossover and can be almost impossible to unpick

Find yourself a proper psychiatrist (doctor with medical degree then years specialist training)

You’re right, it is an assumption. Just going by my experience as a patient and staff (two bordering trusts), but might be different in others. My bad!

That’s a pretty big assumption - I’ve worked in MH for several years and rarely see GPs complete the assessment - it varies by area and GP

I also agree with this. From a patient perspective, it wasn’t until I was medicated and educated and understood my ADHD better that I got clarity on my PTSD and which was which. Without that, I don’t think my EMDR would have been successful.

I’m sorry that you could not get treatment on the NHS but I hope you might be able to see it not as you being undeserving but as the NHS not having the resources to fund the right services for everyone.

It’s not just therapy. There are other good effective treatments in mental health like TMS or esketamine for depression that the NHS doesn’t offer for no other reason than that they can’t afford it and people are having to go private.

I imagine it is the same in other fields that there are people who could benefit from treatments that are not funded.

It’s not you personally being rejected or seen as undeserving it’s that the right service doesn’t cost because it has not been funded. Long term 1:1 psychotherapy will always be an expensive thing and that’s really the only reason the NHS barely offers it.

Have you heard of integrated family systems/parts work? Might be worth looking in to. There’s a book - No Bad Parts, by Richard Schwartz.

It does sound confusing for you - you know something happened but you can’t work out what. It has an effect on you but not to a disabling degree. I wonder what you wish to gain by doing the therapy? Is it knowledge? A better relationship with your mom? More peace in your heart? One of the things I was asked first in my PTSD therapy was “what’s the end goal here? What does your life look like when we are finished with the therapy”?

It’s a good question. Often the end is where we start from…

I thought everyone knew the NHS word for ‘go away’ = complex.

Old person they’re keeping breathing-at-most but refuse to look after = complex

Sick person who doesn’t fit into ticklist as impertinently human = complex

Disease not covered on Google = complex.

I think that looking to disentangle the causes of symptoms on such a fine grain level might actually be an impossible task for any clinician as most things have complex multiple interacting causes. You would be very lucky to find someone who could both diagnose autism and do say EMDR. That’s going to be a rare skill set I think.

I agree with your DH that, as you do seem to have had quite a lot of focus on trauma stuff already, you might be best off to get a private autism assessment and get that question answered and that would then inform any future formulation and therapy.

The GP will have done a triage with a PTSD scale. If she doesn’t fit the criteria for PTSD, they can’t refer.

You cannot get referred to the National Trauma Centre unless you have been through your local 2nd care service and their current wait just for an assessment is of the order of 3 years and then another 2 for treatment. That’s a non starter for the severity of symptoms that the OP describes I’m afraid.

It’s crappy to put the blame on you and label you “too complex”. Dreadful. They should be honest and explain they don’t have the expertise to help you and you deserve more qualified therapists to help you heal. What a victim blaming way to treat people coming for help. I’m sorry you experienced that ❤️‍🩹

You do need to have a proper assessment and treatment plan.

You can get that with qualified psychologist (rather than a counsellor or psychotherapist). It will cost more but they are qualified to diagnose conditions and come up with a treatment plan. Diagnosis is more based on your current symptoms rather than what happened to you.

The other option is to pay for a private psychiatric assessment for your symptoms. Psychiatrists deal more with medication than the therapy side of treatment. They will diagnose and medicate if deemed the right thing.

Pete Walker’s book on CPTSD is good if you’re looking for a comprehensive guide to the condition. DBT is a great therapy for emotional regulation skills (for when triggered or in flashbacks). EMDR is beyond miraculous for trauma.

I hope you get to move past this, as it sounds really horrid for you to be going through.

Great post, @Hotflushesandchilblains , and this is exactly what's happening where I live.

MH services are in a dire state imo. I've had clients with a PTSD diagnosis who have been waiting >4 years for EMDR therapy, and it often takes a year or two to get assessed and referred for it. When they finally get it, it seems to be life changing for most, and often after only a few sessions, so very cost effective. If they have depression and/or GAD as well, these often improve immensely, too.

If the govt seriously want to get people off ill-health benefits and back to work, they should invest more in therapies like EMDR and in MH services generally so that people can recover more quickly.

Look up the NICE clinical guidelines there is a précis here: https://www.ptsduk.org/what-is-ptsd/nice-guidelines-for-ptsd/

These say what you should be offered - then go back to the GP and ask how they will support you in accessing the service you should be able to access - they could refer you to the National Centrehttps://slam.nhs.uk/service-detail/service/trauma-and-dissociation-service-280 or there may be a regional provider or a private provider who has an NHS contract they could refer you to under the Choice protocol - they can also do a referral to the local ICB for personalised funding.

Lots of people with a complex trauma history don’t have dissociative flashbacks for example.

@CharlotteLightandDark @StElwicksNeighbourhoodAssociation the above is completely untrue and un-informed. CPTSD involves dissociative flashbacks that are emotional in nature rather than picture memories and often present as suicide ideation or abandonment fear. It’s a huge component of the condition. Look up Pete Walker’s guide to emotional flashbacks.

@Sillyquestion123 have you read books like The Body Remembers by Babette Rothschild (which talks about the care gap for CPTSD sufferers in the introduction) and Complex PTSD by Pete Walker? I’d recommend them. Also Waking the Tiger by Peter Levine and The Body Keeps the Score by Besel Van der Kolk.

I see you’ve already had private therapy, but was the therapist trauma informed and were they able to spot if/when you dissociate and take you deeper into emotional memories? The past emotions cropping up in the present might be where your trouble lies, so you need someone who can dig into that with you. I found that with a really good trauma informed psychotherapist but it has taken years and years of deep work.

It’s a massive problem that there’s not a clear standard of trauma training or visibility of qualifications and competence of therapists in this regard. There should be because it’s the root cause/bread and butter of everything clients come to therapy for. Really it depends on how deep the therapist has gone in their own work. I’d suggest looking around for someone different privately if you can.

You obviously had some ‘non-shite’ input to be diagnosed with CPTSD

It was a while ago now but I believe I booked the psychiatrist appointment through my local private hospital. Then she recommended the clinical psychologist who then did the EMDR with me. He was through Clinical Partners. I really hope you get the help you need.