Finally started counselling - is this usual?

[DeedIDo]

After waiting two years for this service and five years all told, I have finally started counselling for cPTSD and have had two sessions.

The first session was mostly taken up with 'housekeeping' and a few minutes running through what I said when I had my initial assessment two years ago. The second session was completely taken up by the counsellor drawing up a family tree so that "I'll know who you're talking about". I wasn't expecting that.

More concerning to me is that, since the first session, my heart rate has gone up noticeably and my sleep quality has declined - a lot. I've also come out in eczema, which I haven't had for some considerable time.

Is this other people's experience?

Thanks

No, that's not at all usual. Is your counselling on the NHS or private?

That sounds normal to me,
After such a long time since your assessment it is essential that you are re assessed so that the therapist has a current view of your issues,
The second session also sounds appropriate- setting the scene before getting into detailed therapy, establishing a therapeutic relationship with you etc
It sounds like you are embarking on therapy as opposed to a short course of counselling
It is important that you let your therapist know how you’ve been feeling since starting sessions
A good therapist will be able
To explore your concerns with you, and monitor your response to being in therapy
Best wishes with your journey

That's pretty much how my first 2 sessions with my psychologist went.
The housekeeping didn't need explanation but she did explain why it was useful to have family background. Since we are products of our upbringing it's essential for them to know if there were significant events or circumstances which may have had an influence on us.

This is absolutely essential to set up a solid basis for long term counselling. A lot can change in 2 years and the counsellor needs to be up to date with your current situation. Drawing up a family tree will make it much easier for them to follow who you are talking about and will save lots of back and forth trying to sort out who is who. Also, I imagine they didn't just draw up a tree but also asked you describe your relationship with various key people in your family.

What is concerning, though, is your reactions. Can you pin down why you are so anxious that it affects you physically? Is it to do with reliving the trauma after so much time has passed? Or something else?

No, it's not really normal for a counsellor to spend a whole session drawing up a family tree. They might make a few notes about who is who as you're talking, but this shouldn't detract from the session and is normally done quietly on the side.

I would be concerned that this counsellor is not very competent to be honest (and I have training myself).

When you are working with a client, you should be in their perspective, not your own. Drawing up a family tree is all about the counsellor's perspective and understanding. It's not normal practice, especially not in the first session, because it is basically telling you that the counsellor's understanding is more important than you talking.

They should really just be listening to you at this stage, things become clear naturally as the client talks, and ultimately the aim of counselling isn't for the counsellor to understand every detail of the client's life.

Also, I imagine they didn't just draw up a tree but also asked you describe your relationship with various key people in your family.

Exactly. We didn't sit with a pencil and paper drawing an actual tree, it was more like her making a picture of where I fitted in the family, who the important people were.

This was the consultant clinical psychologist within the NHS. I'm pretty sure she knows her stuff. She also explained WHY she needed that info.

nb this was therapy not counselling so maybe it's different.

Starting therapy/counselling is extremely anxiety provoking. Not surprising that your eczema is flaring up!

Mine is terrible at the moment and I have been in therapy a long time. I think I must be dealing with things that make me particularly anxious.

Thanks everyone.

The family tree is on a massive piece of paper, in all different coloured pens.

This week he asked me if I thought my mother had tried to abort me!

Two further sessions done.

After session three, I had what felt like a complete physical and mental breakdown and two weeks on I am still dizzy, nauseous, struggling to eat (I have lost about a stone) and sleep. I wake up in the early hours and that's it, so am getting perhaps four hours of good quality sleep per night. I've been up since 4am this morning and yesterday was the same.

Therapist says this happens sometimes. They don't warn people about it because it might not happen. He's made no suggestions as to how I might cope with it or how long it might last.

At every session now the bloody multi coloured family tree is stuck on the wall. I can't look at it.

The bloody family tree is still there, pinned up on the wall every bloody time. I sit with my back to it.

I'm more confused than ever now. I turn up. I'm prompted. I talk until I'm told that time is up and I go away. The counsellor doesn't understand why I'm not crying. I thought I might initially and took tissues with me, but there have been no tears.

I'm still getting pretty much constant flashbacks, but there're not so repetitive now. Instead they're about all sort of things that I have recalled since I started the counselling. I've had flashbacks for over five years and I hope I might look forward to a time when they are gone, but I don't think it's going to be any time soon.

Physically I feel better, but I still haven't regained the fitness I had before my collapse in November.

I'm unsure whether to continue, but don't know how I would know whether it's actually going to wor me.

Confused.

I was told this can happen when I had some therapy. My therapist said it was like lancing a boil. You had to get everything out before it could start to heal.

Likely the sessions have lanced the boil and you're experiencing the physical symptoms of all those repressed feelings and thoughts coming out. Once their out you can start to make sense and heal.

Complex ptsd is generally not a quick fix, is the counsellor specialised in this area? As from how you’ve described the sessions it doesn’t particularly sound like it. Not crying is likely linked into it.
It’s right you may feel worse before you feel better as you work through things but having a good rapport with your counsellor is one of the things that helps with healing. And if it’s making you feel very unwell it may be doing more harm than good if they don’t know what they’re doing. Are they aware having a family tree up makes you feel uncomfortable and still insisting on it? If so that would be a red flag for me personally, having seen several counsellors myself I have never been asked to create a family tree. If they are going out of their way to make you feel uncomfortable in this way it doesn’t sound right. Is there an option to see someone else.

I had a therapist ask me to complete a family tree at home after the first session. As ‘homework’.

It completely freaked me out - the idea of writing it when so much of my family is complex.

I didn’t go back.

I hope yours goes well for you OP. It’s such an undertaking and I admire your bravery.

OP I had a few private sessions and one NHS session years ago
(I don't think CPSTD was a term then, but I have found Richard Grannon quite helpful on that.)

They were both helpful but they didn't try to fit me into a frame.

Tbh I don't like the sound of this guy. Your family might have nothing to do with the situation. Have you been given the chance to say what you need from the sessions?

I'm sorry to say it reminds me of two things - also from private therapists

One friend in bereavement counselling, the counsellor seemed to be trying to get her to link up previous bereavements to make more money I think. She also went downhill a lot with the sessions. She stopped after three because there was no healing going on there.

A flatmate with an eating disorder who saw one therapist who wanted to blame her parents and actually got annoyed when she tried to say what she thought had started it off. Then he started asking about wider family. She actually walked out of the second session with him.

I wouldn't want someone who wasn't ready to listen.

If you've recently started therapy it's very unusual to have been diagnosed with cPTSD so soon. That would normally be much further down the line.

Have you asked him if he is a trauma therapist?

The family tree thing is really weird. I have never been asked to produce one, even though all my trauma is family related. "Who's who" is gradually learned over many, many sessions.

It's true that you can feel worse before you feel better, but that should be taken into consideration during your sessions. I'm sorry but he sounds awful and I wouldn't want to be seeing him. You need complete trust and a connection with your therapist for trauma work, it doesn't sound like you have that.

OP, I am a solution focused psychotherapist and hypnotherapist. I establish the issue but then only move forward with my clients not constantly talking about it.

The reason for this is that when you do this, it triggers your emotional brain, which contains your amygdala(and other key components).

You emotional brain exists just to protect you it cannot think for itself. Your intellectual part of your brain does the rstiknal thinking part.

The emotional part of your brain is naturally negative and hypervigilant- if it suspects you are anxious it can keep you in a loop as it senses you are under threat.

This can be why people feel awful after traditional counselling- especially in relation to PTSD. You are firing your amygdala when keeping talking about it.

I know as I was an emergency services worker with PTSD previously. Traditional counselling made me worse and know I know why. I once had to take myself to bed after a traditional counselling session just to shut down my brain.Talking about the issue was triggering my amygdala and keeping me stuck in a negative loop.whstvi needed was to move forwards.

This may explain your flare ups.You may be better with a solution focused therapist instead. Good luck with your treatment.

Umm when I started I didn’t like him and it was just rehashing the same crap week on week and going round in circles. I finally opened up a bit and talked about the abuse in more detail but that was 6 months later - even last week I disclosed some horrid stuff and just by him saying I’m really sorry that happened to you it isn’t ok and it’s clearly on them etc - then suddenly I felt at peace with it - I’m still not telling him everything but I’m feeling calmer and more stable - I think it could be years but I feel better it’s once a week of my time and my healing

Ps I would tell him you don’t want to look at the tree and can they take it down etc

Gonna that's really interesting. I think i have cptsd from abusive childhood. I had some counselling but would be gone for the rest of the day.

I am now being offered 20weeks on the NHS but not starting for a few months. I dont know if they are trauma trained but must be used to their "complex cases?"

Im interested to know more about anxiety as I think my brain is constantly on overdrive/ hypervjgilant and would love to calm it.

ChildHeadache - yes the brain is very powerful. Your behavioural patterns/experiences are stored in your hippocampus (part of your emotional brain along with the amygdala). You will always revert back to these stored patterns.

As a hypnotherapist I use processes to disrupt old patterns and replace them with new ones. This is how I work when dealing with phobias and OCD for example.

You could always try hypnotherapy for free. If you look at the Association for Solution Focused Hypnotherapy -
there are students you can contact for free sessions as part of their training to become accredited hypnotherapists.