CBT for PTSD has anyone had it ? Is it supposed to make me feel worse ?

[GreySue]

I had session 2 yesterday and am really struggling. I had to talk about the trauma and how it affects me and now I feel so much worse. Flashbacks that I can’t seem to stop. I usually function ok ish but this has floored me.

Is this normal ? I am having up to 10 weekly sessions through the MH team but was not expecting to feel worse. I am hoping that I don’t feel like this after next weeks session and start to feel better.

Has anyone been through this that can reassure me about the process?

I am worried that I will need to take some time off work as I literally am crying a lot and can’t function mentally well at all.

I didn't think CBT was appropriate for PTSD. Although it is listed on the NHS website www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/treatment/
EMDR is what I've heard used more.
I have also heard of Present Therapy which focuses on the hear and now and doesn't probe the trauma

Unfortunately yes i did find that with cbt. You dig right into the trauma and then the session is over and you just have to cope on your own until the next session where you do it all again.

I found EMDR was far better. It was still very hard but you don't have to talk about every situation that happened in detail - you pick one example and work on how you felt about it. I found it worked much quicker. I had about 50 sessions of cbt which helped my anxiety but did nothing for ptsd. Emdr mostly cured my ptsd.

Please make sure you tell your therapist. It sounds like it's going too far, too fast. Does she know you have PTSD? (Rather than anxiety in general for example). If you like reading, the body keeps the score is interesting although it is long!

Yes, it made me, temporarily, worse, but then much better. It was not a fun process, but it did function a bit like draining the wound. I had some rough patches during the CBT but by the time it finished I was doing much better. I haven't had EMDR, so can't compare.

I found CBT did nothing to help with PTSD. Ring the service who you spoke to yesterday and say what you said above. Hopefully they’ll do something in the short and long term x

CBT is not always right for PTSD. Please email your therapist about the fact you are experiencing flashbacks etc. and ask them to re-evaluate the approach.

I'm really sorry this is happening

Act therapy much better in my experience x

In response to other posts CBT is a NICe recommended intervention for PtSD so perfectly appropriate. I am sorry to hear that you weren't warned that it would get worse before it gets better, that's really normal and you should have been told. Did you set up any coping techniques or safe place imagery in therapy that you can use?

Do tell your team and therapist though, it's a really normal reaction but they may be going too fast.

I have a diagnosis of PTSD and this was session 2. I had an initial assessment then was fast tracked for treatment as they have just started doing this for people with long term health conditions. My trauma is around life threatening medical issues that can’t be controlled.
I wanted coping strategies to allow me to live with this illness and future traumatic episodes and was reassured this therapy would help me.
I don’t have the energy to question the professionals I want to feel better.

I found EMDR for PTSD horrific but successful, for similar reasons of just revisiting in great detail traumatic events. My psychiatrist did recommend breathing exercises for in between sessions and gave me contact numbers for if I needed extra support.

@eatyeateat no warnings and no coping strategies yet apart from ‘self care ‘.
I am an expert in what I should be doing for self care but struggle hence seeking help to cope.
I will bring up next time how I should have been warned as we discuss my fears around being able to maintain my job. I am a single parent to teenage twins and need to work to keep my family afloat.

I work with PTSD and find there's no need to revisit it in any great detail - you know what it was so why have to dig into that wound yet again. Your subconscious mind needs to know it won't happen again and it wasn't your fault; once that is accept the emotional link to the past events is broken.

OP my therapist taught me a technique to ground myself in the present which I used between sessions; do you have anything like that?

It was this, essentially, using all 5 sensed:

@DreadPirateRobots thank you that is helpful.

@Eyesopenwideawake unfortunately it is very likely to happen again and has happened multiple times over the last few years. I was told it was a new service to help people with issues with long term and unexplained medical conditions.

OK, so you need coping strategies for as yet unknown events which are likely to cause trauma?

No for life threatening medical episodes that I have been having and are likely to reoccur and cannot be controlled.

CBT covers a lot of ground

There is basic CBT for depression and anxiety that IAPT type services provide and there is much more sophisticated CBT done by qualified clinical psychologists for major issues like psychosis and trauma.

Trauma focused CBT has at least as much evidence for PTSD as EMDR hence the NICE recommendation just EMDR is flavour of the month. Either therapy can be done well or done badly and either can help or harm. Honestly for all modalities of therapy there is a tonne of evidence that it's the therapist more than the therapy that is most important

For most therapies for serious conditions you do get worse before you get better. The first sessions should be assessment, formulation and teaching grounding strategies

Absolutely talk to your therapist and explain how you feel and if they are good they will modify it.

It is pretty hard to have effective trauma therapy whilst the trauma/ threat is ongoing however...

That's tough, I'm sorry. It is possible to 'train' your subconscious mind to deal with uncertainty and to live in the moment rather than project into an unknown future.