AIBU to feel worse after therapy for past trauma?

[NotSureThisIsWorking]

Hi wise mumsnetters, name changed for this,

I am 35years old and I’m new to therapy.
I’ve recently (last 6 months) had a strange sort of resurgence of traumatic memories and very negative thought patterns. It’s not like I have just ‘remembered’ being these traumatic events relating to teen sexual abuse but I’ve somehow managed to just not think about them for years until now.

I know that an event where I didn’t feel safe at all about a year ago has brought this on.

I started feeling anxiety a lot of the day , racing thoughts especially at night, night mares and waking up to panic attacks, low mood, feeling shit about myself and like there is something wrong with me and an increase in disordered eating and wanting to control food. I feel like I’m falling apart basically.

For my own, and my kids sake, I decided to do weekly therapy before considering the medication route . I like my therapist and I feel safe with her. I find it very hard to talk about some of the trauma but I’m opening up slowly. I never cry in therapy, is that normal? She’s says it can be. I feel close to tears sometimes and I feel sick and anxious but I never actually get upset. I don’t know why. I’ve been going about 8 weeks.

My issue is that I feel AWFUL after. I cry a lot and just lay in bed, or I punish myself by going for a long run until I’m almost throwing up to try and block the thoughts out, I slept terribly that night and usually have a panic attack from the intrusive thoughts about the trauma.

I would like to know if this is normal ?? Or if I should stop …

It is normal, yes. For a time at least. I used to feel like I was coming down with the flu or had a terrible hangover after therapy sessions. It didn’t last forever though. How long have you been in therapy and what sort is it? What’s the plan or your goal? I think one thing that isn’t helpful is spending years talking about bad stuff and never finding a resolution or a way to move forward.

You have to spend some time in the trenches first. But eventually you should be moving through to the other side. One other thing to consider is if it’s the right sort. For example, EMDR may be more beneficial than integrative therapy or psychoanalysis.

But yes, I did feel awful, especially the first 2-3 months. By the time I stopped (5-6 months), I felt much better. Overall, it’s made a tremendous difference in how that trauma impacts me now and I’ve been able to sort of process it and leave it in the past to an extent that I’m living a happy life again.

I have heard you feel worse before you feel better. It makes sense as you are focusing on very unpleasant memories/feelings. I'm so sorry you're having to go through this, you are very brave. Have you talked to your therapist about this? I'm sure she could reassure you. I get the 'punishing' youself thing, maybe mention that to your therapist too. Very best of luck to you, again, you are being so brave, I wish you well. X

That’s normal in my experience. I’m sorry you’re struggling.

At eight weeks, absolutely normal. You’re trying to start thinking about something you’ve suppressed successfully for years.

Trauma therapy does often involve feeling worse immediately following. I have personally benefited enormously from EMDR. It also tends to make you feel worse immediately following and then slowly tapers off, but the benefits are huge and you don’t actually have to do much talking.

Yes, it's normal. Less so with EMDR but I actually had horrendous reaction to it and went back to talking therapies. Horses for courses, as they say.
I also agree with the PP that there needs to be a very clear goal for therapy in your mind because it is easy to get stuck in reliving trauma with a therapist for years and never learning tools to deal with it. If your therapist is any good, they will spot it and redirect you to more proactive self-management. But it helps to go in with an established objective rather than just to "talk about it".

Please tell your therapist how you feel after sessions. These feelings can be worked with. They are to be expected when using talk therapy for trauma and you can slow the pace a bit, negotiate with the therapist safe topics to talk about for short breaks during sessions, explore ways to regulate your feelings outside sessions.

Yes normal. It unfortunately tends to get worse before it gets better. It does get better. I used to vomit afterwards when it was a particularly difficult session. Headaches and tiredness are still not uncommon.
tell your therapist, they should be able to make suggests and help.
fwiw. I try to plan sessions after work/must do stuff and I walk it off through a park listening to music like a ritual. Decent food, yoga, hot shower and a clean warm bed. Basically try to be kind to yourself in whatever way works for you.

I did EMDR a long time ago, with sounds. The therapy was really effective for me and worked quickly but it left me feeling kind of hung over or spaced out the next day. I did it about 4 years after the event.

I think you need to tell her clearly how awful you are feeling afterwards. If she is a skilled therapist, she should be able to slow things down, or teach you techniques to manage the emotions this is bringing up. Look up the 3 phase model of trauma therapy - the first phase should be stabilisation, making sure you have the tools to keep your life stable, before you start to approach processing the memories.

It's normal for therapy to be hard, but if it's making things worse, it's bad therapy.

I used to be so tired I had to cancel meetings afterwards when I did therapy at lunchtime. I ended up having to do it in the evening after work, and would fall straight to sleep when I got home, often without even getting upstairs.

I think it is normal. My therapist said that the hardest part of therapy is the time between sessions. Therapy usually left me feeling quite drained, and then I would end up dreading it and getting anxious before the next session. It was incredibly expensive. Maybe I have just never found the right therapist

I’ve always felt awful after therapy. Because I dislike doing it. I’m not a talker naturally and I am a performer rather than always truthful. It can be really hard for some of us to do therapy because it goes against all our protective instincts and it’s uncomfortable, upsetting and exhausting. It’s also hard to go from therapy space to suddenly back to kids/chores/work/friends.

Thank you everyone for sharing your experiences, I can see the common theme is to tell her!
in terms of what type of therapy it is it’s talking therapy and we do some techniques in grounding, managing anxiety and panic attacks. She hasn’t mentioned any specific EMDR or anything , not sure what that is?

Im 8 weeks in and minding my mind is not a nice place to be at the moment. If I am busy, working or doing mundane parenting tasks, or exercising I am coping. If I am left to my own devices i feel I am not coping at all . It’s not a nice feeling at all

Also I find it weird I get the feeling I want to cry but I never do in session… it’s strange

Are you practicing your grounding techniques outside of the session in those quieter moments? I found that frequent practice was the key for me. Usually, I'd be able to break the thought cycle with tapping or mindful breathing. It was hard at first but now works like a clockwork after months of consistent practice.

Perhaps crying makes you feel vulnerable? Or you hold it together in the session and it overwhelms you afterwards?

I’m a therapist and yes this is normal. Therapy often makes people “worse” before it makes you better. It’s a bit like therapy and talking about things takes the lid off so everything can then come out but give it time you can sort all of what comes out and put it back in neatly.
tell your therapist she may need to show you more techniques of managing the distress your feeling after the sessions. If you feel comfortable with your therapist if say keep going

Emdr is a specific form of therapy op that your therapist wouldn’t be doing unless trained in it

It's normal. Very much so. I'm about 3 years on from where you are now and I promise it does get better. Just that to process and, I guess maybe integrate is the word? those memories, you have to look at them and you have to experience them again without your brain doing its whole if-I-don't-think-about-it,-it-didn't-happen thing.

I didn't cry in session either for months. I think I actually picked fights with him before I cried in front of him. Its just how emotions come out. Go easy on yourself. You're doing amazing just by turning up and talking.

I don't agree that it's normal.

It is normal to feel worse at times yes, because you're taking about distressing difficult stuff and strong emotions are an understandable response. However... when delivering trauma therapy, the first part of usually about stabilisation / preparation: building up internal resources so that you have ways of coming back from the memories or containing them more safely between sessions. When I had EMDR, I remember being asked to create imagery for a safe space and a compassionate other; to visualise and get in touch with my inner strengths; to learn some grounding and relaxation techniques. The concept of 'window of tolerance' was introduced to me as a way of checking that I was connecting with the memories without being driven to unbearable distress. We discussed self-care ideas for things I could do after appointments to feel better too. Not all of it worked well for me but some bits were very helpful.

CBT for trauma is a bit different and might not involve the same level of prep but if I recall correctly, the most commonly used treatment protocol starts with a focus on reclaiming your life by scheduling more time for things you care about etc, which also comes back to looking after yourself outside of sessions really and building a sense of freedom from the impact of trauma.

I definitely echo those saying you should tell your therapist how you're feeling and what you're doing after sessions. They might need to pause discussion of the past whilst they help you find more tools to help you with the emotional fallout.

Also: I'm really sorry for what you've been through and for what you're experiencing now. It sounds really tough. Punishing yourself, trying to perhaps over-control other areas of life and trying to push distressing memories away are all sadly common and understandable ways of trying to cope with awful thimgs. Hopefully therapy can help you find some freedom from this. Wishing you loads of luck - it really can help she much but perhaps something is missing at the moment in terms of your therapist's understanding of what you need.

Both crying and not crying are totally normal and fine. All emotional responses are sort of fine. Sometimes things hit us in different ways and places and that is a very personal thing, not a sign of anything wrong with us. There's no rule for how you should feel or should behave.

Yes, I feel like this too. Just completely spacey and drained.

I have had a lot of therapy and a lot of different kinds of therapy and I have never cried in a session even when discussing traumatic or distressing past events. To be honest it is rare that I cry in front of people, even in response to bereavement I have usually cried alone. It’s not even that I don’t feel comfortable, sometimes I want to cry and wish I could let it out but I think the act of talking with someone kind of blocks the ability for me to cry. Often I will be unable to cry when someone is there and then the second they leave i start sobbing but then if they come in again I stop again. It’s like a block for me, but I have still found therapy useful even if I’ve never cried in it.

I'm going to dissent here and say no this is not normal after 2 months of therapy. The first few sessions yes, but you should have had a noticeable change in your mood and coping by now if the therapeutic style and interventions are actually working. Just talking about stuff is obviously not addressing your cardinal symptoms which might respond better to a combination of medication and therapy. If you have such low moods, racing thoughts and nightmares, on the back of a traumatic incident you could have PSTD or depressive disorder in which case I would recommend you talk to your GP about whether seeing a psychiatrist might actually be better for you. Best of luck.

Does your therapist not tell you what to expect and what is normal when memories resurface? Surely she should be preparing you for this reaction and how to manage it.