Therapist argued with me that C-ptsd does not exist

[insightopedia]

I had seen this therapist before and stopped therapy as he used to be pushy and strong in his opinions.

I needed to start therapy again and after frustrations of not finding an empathetic one , I decided to try him again as this therapist is highly qualified, has mentioned different therapy approaches on his profile - cbt., schema, compassionate focussed CBT, EMDR and many more.

So I had my 1st session with him 2 days ago. I said I think I have complex ptsd as I seem to have symptoms, had a lot of childhood trauma and difficult relationships recently.

He said I don't have PTSD. For PTSD, one has to have a near death experience.
I told him I am not talking about PTSD, it's complex PTSD and explained a bit about it. He said I should stop reading on wikipedia. There is nothing called CPTSD. Then he got up and went to get a book (DSM manual) and open the chapter on PTSD and showed me that. I told him there are books written on C-PTSD and he laughed it off.
I told him I felt dismissed and he said I speak very fast and it is overwhelming for him.

Even early on in session when I was very calm, I found him dismissive, not letting me finish sentence and speaking over me. It was like he needed to lecture me without even understanding what I was saying.

I am very confused. I feel I shouldn't go back to him. At the same time I need help.
I went to him specifically for schema. He told me that schema takes long. I asked him approximate minimum number of sessions. He said he doesn't know. He said in extreme personality disorder it is over a year but said I don't seem to have any personality disorder. Still couldn't say an approximate minimum duration for me. So I don't know if therapy is for 6 months, 1 year, 5 years.

I need to self fund it. Also he is not willing to talk about the goal of therapy. His answer was on the lines of he doesn't know what happens after we finish whatever required number of schema sessions.

The reason I am confused is that I have spoken to 3 therapists - all very highly qualified and found them all dismissive and eager to speak. I now feel I should avoid PhDs with 20 years experience, perhaps such rich experience and qualification make them overconfident and they think they know better than patient/client about her problems.

He also said he needed to challenge me. For what? As some of things he told me, I was in agreement with from start. He didn't listen/ understand what I was saying and was ready to counter answer.

In the end of session, I told him I felt we argued over C-PTSD and that I might appear okay in the session but I am going through a lot and have no support so expect a little gentle approach. He said next time bring with you what you have read on CPTSD, I would see.

I googled again CPTSD is not just on wikipedia, NHS, mind, etc recognise it as a mental health condition.
www.nhs.uk/conditions/post-traumatic-stress-disorder-ptsd/complex/

www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/complex-ptsd/#.XO58jS2ZM6g

Please help me decide if I should go back to this therapist. My gut feeling say I shouldn't but I can be wrong.

I'm sorry that happened. I would say that it doesn't sound like you're a good match - but also that if you've seen three other therapists and found them all difficult, it might be worth considering what you're doing that is contributing, as you are the common denominator.

Is it possible that you're giving them the impression that you want to do their job for them? That you know more than them? That wouldn't contribute to a successful therapy relationship.

To be honest, and I mean this as kindly as possible, if you have spoken to three highly qualified therapists I suspect that the issue is with you.

It is coming across quite strongly that you think you know better than these qualified professionals and dislike having your views challenged.

I'm sorry you are struggling.

It seems that your not a good match. Do you prefer person centred therapy? Instead of looking at all the PHDs someone has maybe look at the type of therapy they do and/or counsellor and talk to them as it's important that you have a connection with them. I'm currently studying to be a counsellor and see the importance of being heard and allowed to talk as a client.

Are you ok the UK I'd so what county as the NHS will normally start with CBT then go onto different types of therapy.

Sorry op but that therapist sounds dreadful.
I would consider looking for a psychodynamic counsellor that can look into your past with you.

It sounds like you would be best off to trust your instincts and find another therapist.

No matter the level of experience, technique and theoretical basis, the most important factor in having successful therapy is that you have a good relationship, a deep therapeutic alliance.

So much of that connection comes from base human instinct in the same way as you are attracted to people romantically or in friendship.

This man sounds arrogant and isn't listening to you. Find someone who does.

There are differences of opinion in the psychotherapy and psychiatry fields about many of the disorder/labels. I would expect a decent therapist, even if they don't 'believe' in cptsd to explore with you what you think it is, what it means to you, how it helps you to understand yourself to apply that name to your condition etc etc
Regardless of the label the symptoms remain the same and these are what needs addressing and what you are seeking help to deal with.

In terms of how long, that is indeed a difficult question. For deep therapy probably look to do a year, with a check in with yourself every few months as to how it's going and how you are feeling. Keep going if you want to, dont if you don't. It is your decision, not your therapists. Short term counsellor will start with eg a clear frame of 12 sessions. Within this they will guide the work to what is feasible to address in a short time frame, not delve too deeply.
Do talk to the therapist about time frames, but don't expect a clear answer from the outset because they don't yet know how much baggage you have to unpack.

I suggest going onto the UKCP website and browse the therapists in your area, call a few you like the look of, you can have session with a few if you want before deciding who to work with. May seem extravagant but it's a bit like dating and then deciding who to go into relationship with.

Sorry, just realised how long this is! Hope at least some is helpful
Good luck!!

I think that a therapist needs to believe you in order to help you so he is not a good match. You clearly are struggeling so something is wrong and you need help for that. I do find it a bit worrying that you have been dismissed by so many therapists, apparantly how you come across and what is bothering you don't match. This is a problem in itself and you might want to clear that up first with a (new) therapist during intake to see how you can communicate together effectively. I don't see how you can get the help you need till you have found a way to deal with that. I hope that you find the help that you need.

I would not go back. The biggest predictor in these things helping is engagement with the therapist or counsellor.

People who provide Therapy/ counselling will have their own perspectives some favor medication plus taking some very anti medication, some focused on diagnosis some very anti etc.

The only important thing is finding someone with the right fit for you. Make sure they are accredited. Some offer a free 20 mins to see if it feels right for you. (The counsellor I have just gone with offered this.)

Saying this gently: It sounds like your need to control things/be right/know the most is interfering with therapy.

Therapists tend to specialise or gravitate towards an area of counselling but it surprises me he hasn’t heard of c ptsd. I’d say go with your gut and find someone else if he doesn’t take you seriously. Complex ptsd definitely exists! They are loads of books on it. You are partaking in therapy voluntarily and shouldn’t feel looked down on but supported even if he disagrees with you.

Also ignore all the naysayers saying you’ve got a perception problem. Not particularly helpful on a mental thread

Thanks everyone for your replies. Just to clarify I did not try to control or show I know more than therapist like some posters suggested.

I had contacted him for schema therapy.This was first session and he asked me why I am interested in schema., So I said was diagnosed to have complex trauma by Bupa diagnostic therapist(they call to do an assessment before they authorise treatment) and looked it up and read about c-ptsd and I seem to have the symptoms.
He snapped back (he responds in a reactive way, not very gently) that there is nothing called C-ptsd, don't read on wikipedia. That's how C-ptsd topic got started.

I had seen this therapist 2 years ago and he was pushy last time but since I am struggling and I am partially using BUPA insurance for payment, I had to go with a BUPA authorised therapist and there are not many who mentioned schema on their profile. Also many were not taking patients for next 2-3 months.I told myself I will look past pushiness as he is very educated.

My other 2 therapists were - a therapist who invented and trademarked his own approach and was very rigid.
Other therapist seemed not so involved and made one-liner comments,.
I agree I am a common denominator. I am very sensitive and notice these things.
I have never thought or conveyed that I know more than therapist.

But I definitely find it very arrogant for any therapist to assume they know more about my problems and don't need to listen. This is the point where I start giving up on therapist. I feel any empathetic therapist would be aware that being heard is therapeutic in itself.

I have to admit one of the criteria I used was Phd qualification.

I have a lot of childhood trauma, denial of traumatic experiences by family and recent trauma. Just narrating those incidents re-trigger the trauma. I get flashback nightmares. So I don't want to do pure psychotherapy.
Now I am very depressed and it affects my day to day practical life as well. I have only 9 sessions allowed by Bupa then I need to pay myself. Thats why I need some idea if I need to pay for 30 sessions or 60. This therapist says it could be anything. His fees is £100 per session, I need to budget it.

Thanks bumpertobumper Your post was very helpful :-) I will check UKCP website.

Thank you ainsisoisje.

cakeandchampagne I don't have a need to control/ be right/ know more.
I would end up spending over £ 3k on therapy and I feel I have a right to evaluate my therapists.

I don't think this therapist is right for you OP, as others have said the relationship has to be right for therapy to work effectively and you need to trust the therapist.

Having said that, I think you are alienating these highly qualified professionals by turning up and self-diagnosing your condition. I think you need to be prepared to start a bit further back, talking more about what your issues and concerns and letting them help you to agree a path of therapy that you both think is right for you.

I personally wouldn't choose a therapist based on whether or not they have a PHD. Therapy is very personal and evidence suggests it is the personal relationship between the therapist and client that is the biggest indicator of positive results rather than the amount of theory a person knows.

Most of us have met good listeners and that skill is not necessarily related to the level of qualification although clearly you need someone who understands the theories.
I would tend to look for someone who classes themself as integrative or holistic. They will (or should) work out the most appropriate combination for you rather than following a specific style.
Ultimately though your relationship with the therapist/counsellor is the biggest predictor of success.
One thing in my experience is that in a very very general way male counsellors are more likely to go for solution based theories (CBT) and females more humanistic (gestalt/Rogerian) although obviously this cannot be relied upon.
When I did my diploma, which was meant to be humanistic focussed one of the tutors was very CBT focussed and the other less so. (Both male). I found the CBT guy was pretty controlling and wanted to fix people which didn't fit with my idea of counselling at all. CBT is a great tool in many situations but to me not the way he used it.

@insightopedia I have sent you a pm.

Also I'd recommend what pp's have said, you need a therapist that is a good fit & look at the type of therapy & areas of expertise they offer rather than their qualification level.

It sounds from what you've written that possibly psychodynamic therapy would suit you as there is use of transference & countertransference when exploring schemas.

Thank you for your reply Hecateh. This therapist is male and not from British (not being racist as I am myself asian), but I found him a bit dominating and over confident. He also uses mostly CBT but has done brief trainings in other approaches, so is aware of them.

I agree I want to go to a female. I come from a very dismissive background, and perhaps that makes me more sensitive.

Thanks Georgia I am really not self diagnosing. I think you have made that assumption as I mentioned Cptsd to therapist. Therapist from insurance company told me I seem to have complex trauma after doing an 45 minutes assessment. I just mentioned it to this therapist and he refused CPTSD exist. I didn't self diagnose and if a therapist can't handle that I don't want to risk my time and money with him.

Therapist still wants to see me, but I am not sure.

My issue with other therapists were different. I have mentioned in my further posts. In general, I don't trust over-confident, non listener type personalities.
I am told I might be in therapy for long and it's a commitment of long time and a lot of money and I want to be sure.

I'm a therapist and I just recommend you find someone you like, who you feel respects you and who you feel listens to you.

Good luck

Thank you MrsEdinburgh. I will chat with you there :-)

Everyone, thanks for your replies. I would request some of you not make assumptions about me. I am neither trying to control, show my knowledge or self-diagnose. I grew up with alcoholic father and controlling grandparents, my other parent was emotionally dependent. I have very dysfunctional family and I have some self sabotaging patterns myself. I am desperate for help and want to work in therapy to break those patterns. But I can't deal with 'know it all' type of people. Maybe something to do with growing up with very strong personalities. But right now I am very sensitive.

I am really grateful to all of you taking time to write.

Btw, 'know it all' was for therapists not for any of you.

I work in mental health and C-PTSD is a relatively new concept so perhaps he is just not up to speed! (Although clearly he should be!!) Where I work they use DBT for personality disorders, have you looked into that at all? It can be quite challenging but I do have experience of being supervised by DBT therapists at work and found them
Incredibly supportive, and they place a huge amount of emphasis on the therapeutic relationship, which as everyone else has pointed out is very important and the therapist and you have to "fit", as it were.

Is this therapist BACP registered? If you think his approach to patients is wrong and he is denying the existence of some mental health conditions you can report him to the BACP.

In your shoes I would find someone else, see if you can get recommendations from anyone, use the BACP website to find different practitioners in your area. You might be able to find one who lists cptsd amongst their work. Sometimes you just don't click with a therapist. I've had a 50% success rate. Seen four different therapists (two nhs, one university funded, one private) and have only got on well with two of them.

Depending where you work you may also have an employee assistance scheme who might be able to help you find appropriate counselling.

I think its essential to have a therapist you feel comfortable with for therapy to work. Not to say one that never challenges you, but one whose challenges are framed in a way that you find helpful. The approach they take needs to be the right one for you. Therapy is such an intense and personal thing, and you're often feeling particularly vulnerable when seeking it, it makes sense that it might take a few goes to find the therapist you click with. Most of us meet quite a few people before (if) we meet someone we fall in love and want to have a long term relationship with- the therapy relationship is very different but involves a certain level of intimacy. If a therapist isn't for you, they aren't for you and there's nothing wrong with holding out for the right one.

I am not qualified to make diagnoses but I do work in mental health. Whilst your therapist is right that C-PTSD is not included as a separate condition in DSM5 I don't think he's right to say therefore it does not exist! I have worked with child and adult patients with that diagnosis, made by experienced psychiatrists. I'd find a therapist insisting that if something isn't specified in DSM5 it does not exist quite concerning.

UKCP therapists have to be educated to level 7 (so Masters level) to be able to register with that body, so it might be worth looking at them as you were interested in the qualification.

The website lists what area the therapist works with. You’d be looking for someone who works with trauma and abuse. EMDR is another thing to look for, the NHS recommend this as a trauma treatment, so someone working with trauma is likely to have trained in this as well.

With your background you’re most likely to have hyper vigilance, so will be picking lots up from the therapist. The relationship is the most important factor in therapy - research shows that the quality of the therapeutic relationship is more important to outcome than the modality (eg CBT, psychodynamic, person centred, integrative).

I’d also suggest psychodynamic or integrative, if integrative I’d suggest looking for a relational-developmental approach.

He is right in that CPTSD isn’t recognised in the DSM V, but it is known to lag behind current research as it takes so long to produce. The DSM is the American diagnostic manual, the IC 10 is the current UK one. There is discussion about complex trauma being added to the IC 11 when it is produced.

You shouldn’t have to do his work for him, but if you do go back, Pete Walker has a book and website regarding complex trauma. Judith Herman is the person who distinguished between single incident trauma and CPTSD - prolonged repeated trauma.

I have diagnosed PTSD and CPTSD. Your therapist is wrong and has very dangerous views he expressed to vulnerable people.