Finally having therapy! Tips please

[Dorim]

I had an extremely traumatic childhood with 5 ACEs. I am now early 50s and have signed up for therapy on the premis of work related stress as I have burn out and signed off sick. But how do I bring up the awful trauma stuff? At the moment conversations with the therapist are quite light - am I sleeping, exercising etc. is it even worth bringing up the trauma? It obviously affected me but so long ago. I feel the therapist might be surprised as she seems focused on dealing with current/ recent events. I am new to this and would love any advice. Also will I need therapy for a long time? I am not sure how long I can afford.

If it's difficult or awkward to talk about then write it down in a letter or email him/her. If they can help you themselves they should be able to advise you on your options. A good therapist should be prepared to hear anything.

As an aside I work with trauma and the commonly held views that it has to be long-winded and painful are not necessarily true.

Just bring it up, as you clearly want/need to. An experienced therapist will be glad you've brought this to the session and will follow your lead. It doesn't necessarily need years and years of therapy. But bringing it into the session will make it all much more real and valuable to you. Good luck.

Well done! I had six sessions with a brilliant NHS therapist and it really made a difference. Are you limited to a number of sessions? Is it paid for by work like Health Assured or similar?

Sorry I just re-read and you are paying for it yourself so really need to get the most out of it. Have they asked about your childhood or early experiences? Do they start the session asking what you want to talk about?

They start the session asking how my week has been. To start with I was averaging about 4 hours sleep a night and was a wreck but things a bit better now. I want to change jobs so we talk about that. Also talk about issues with my kids. But nothing deep. I will try bringing the other stuff from the past up. It definitely affects me now as I am scared of change or saying no

I paying £60 a session. Was thinking I might stop at Xmas but not sure if that’s long enough

Also can I ask my therapist questions? I ‘d like to ask things like if they have children , what they did at weekend. But worried that is not what I should do. It feels a bit weird talking about myself so much

You don’t need to ask them questions about themselves. It is an unequal relationship but that is because it’s about you! You could share that you want to share though and just name it :) might open up some other conversation or avenues. It’s interesting that your goals and wishes for the therapy weren’t discussed in the first session or two, but it sounds useful to bring up that you’d like to discuss your trauma. May depend on the type of therapy the therapist offers what they do with that but openness about you concerns can only help you get towards your goals! It’s your therapy :)

Well done for getting this far - many don't. Definitely bring it up, and if you feel ambiguous about whether it will help/is relevant, say so. I'm no psychologist but I've had about 40-50 hours of counselling in total & I would say it is very likely to be relevant. Just the phrase "scared of saying no" says something to me about attitudes formed in childhood. People-pleasing often is about having had to appease a parent or caregiver.

My advice, fwiw:
• Take notes. Write something down after each session, even if it's just an upsum of what you talked about (it's amazing how hard it can be to remember! - but that's part of the (my?) problem: you may have learned to pass very quickly over intensely emotional experiences, sweep them aside, essentially). Without notes, you can sometimes spend the first half hour of a session just getting to where you were at the end of the previous one. Eventually, the notes become a very useful aid to further deep thinking.

• Be honest: the temptation to say stuff that pleases the therapist/puts you in a better light/minimises your problems is very real. Take your time. Some of my most useful moments in counselling happened after I sat in silence for several minutes, stumped by how to answer a question truthfully, trying to understand why I was finding it so hard. There's no point glossing over stuff in therapy; whatever else it is, it's Honesty Hour - to your therapist, yes, but also to yourself.

I wish you well.

As you know your history is at the root of your issues then you should tell her that. She needs to know the cause to help you learn how to manage the effects. If her style of therapy is to solely deal with the here and now, she may refer you to another therapist who will delve into your past with you.

Try it and see. A decent therapist will navigate this and work with anything you bring into the room.

Ultimately, it's your time you're paying for...so bring up what you want to discuss.
However, even the modern day stuff and the behaviours you exhibit will be influenced by your ACEs, so although it might "seem" surface level to you, your therapist will be reading under the surface.

Good luck!

I agree.

OP what do you mean by 'on the premise of work related stress?' Do you mean that's how you convinced yourself to start therapy, or what you have told others? I'm glad you're paying for it yourself and can see that awful childhood experiences may make it a longer road. You can frame it however you want: say you're not sure whether this type of therapy is for historic stuff but you think you need to talk about x and y. The therapist may be responding to what you want and be able to adjust her approach. Most ask at the outset what you want from therapy but perhaps at that point you said it was work stress that had brought you there? But that can change. Be as open as you can.

I know people who've gone into therapy/counselling thinking in terms of a "magic bullet". Not saying you're doing that, but it's completely understandable to wonder "where will it end/how will I know?" I see it as finding out more about how I tick. We're mysteries to ourselves, largely - and that's fine if it's not causing problems. So, at the risk of sounding trite, therapy is a journey into self-knowledge. Doesn't stop you feeling X or Y, but you know more about WHY you feel it - and that's often the key to releasing yourself from its control.
Expect a lot of "and how did that make you feel?" & "how d'you think you'd feel if" questions. Just be as honest as you can. Scared/angry/glad/indifferent/I'm not sure, I need time to think about that.

I was signed off sick with burn out and the dr suggested nhs therapy but there was a waiting list. So I just thought I might as well just pay it myself to get going quicker. I will try bringing the other up the childhood trauma. I think in some ways I am embarrassed - I have told no one, not even my dh knows the extent of it

(I’m a therapist)

well done at doing this, the therapeutic journey can be hard. But you’re giving yourself a gift to focus on you

With 5 ACE’s you may need longer, if you can afford it then carry on until you feel ready to stop

It completely depends on the progress that how much time will it take. You will have to be patient and consistent while taking therapy as the progress of it is gradual but it does bring a positive result. They will work on each of the triggers and the therapist is dealing on your current issues first because when your existing issues will be sorted, it would be easier for you to proceed and you will have more faith that something is improving due to the therapy.

If you’ve told the therapist you’re there because of burn out, that’s what they’ll focus on. It also depends on the type of therapy - something like CBT is focussed on the here and now, how you function day by day rather than your past. I’m also going to say working with trauma is a specialism, not every therapist has the training or depth of experience to work with trauma safely, nor does every therapist hold trauma clients on their case load.

In your shoes I’d start by checking your therapists modality (way of working), for childhood issues you want someone with an understanding of human development eg psychodynamic or person centred. I’d then check their training, what level are they qualified to, I’d be looking for post graduate qualifications with a clear focus on trauma. I’d then look at their experience level, are they just out of training or have they got experience behind them, what kind of work do they usually do. You can ask your therapist about all of that - they won’t think you’re being rude - just explain you have some early experiences you want to deal with and ask them to explain whether that’s work they do and what training and experience they have.

Theres a world of difference between someone trained to diploma level used to seeing clients for 6 sessions of EAP work and someone trained to Masters level used to seeing longer term clients with childhood trauma.

Thank you - this is really useful. Therapist is level 5 qualified - so possibly not as high as I need. I’ve paid up front for 6 sessions. I guess I could leave after that. It’s really difficult as I expect the more qualified will charge more and not sure how much I want to invest

Not necessarily, I’m qualified to masters level and charge the same amount - the market sets the price. I wouid avoid people who charge for blocks of sessions because it may not be the right fit, or they may not be able to work with your presenting issues and getting your money back can be tricky.

If you think this therapist is right for you, good relationship and you feel you’re making progress it’s worth talking to her, but be prepared to change if it’s not working for you.

Please don't assume they're not able to manage it.
Level 5 is incredibly qualified and experienced!
Counsellors work ethically, so if you revealed something that was above their expertise, they would refer to on to a colleague that could support you. That is part of their 'oath' as such, that they have to be competent to deal with the clients issues.