CBT or psychotherapy after an abusive relationship/rape

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Does anyone know if it matters which way round you do it? Or is one better than the other? I was told I would benefit from both but I can only do one at a time through the NHS. Any thoughts greatly appreciated, thank you.

If you are having difficulty processing your thoughts, experiencing flashbacks, or are conflicted by what has happened to you, you are best advised to engage in a course of cbt before embarking on pyschotherapy.

If you respond to cbt and become able to exercise control over your thoughts, this will prove an invaluable tool should psychotherapy uncover deep seated traumas and hurts from events which pre-date the abusive relationship you entered into.

I had CBT through a counselling service at work and found it a bit of a drag to be honest. I was reluctant to talk about issues and ended up just dancing around them and I felt like we weren't really getting anywhere with solutions, it just opened the can of worms and made me feel a bit worse than I did when I was ignoring my problems. And I only had 8 sessions, extended from 6, which is hopeless for solving such a massive thing. I think NHS provisions are similar?

However, it did give me a bit of a kick to sort myself out, and kind of gave me some clarity on where my problems were. I'm now having long term psychotherapy to discuss all sorts including abusive relationships (I'm 18 months in and haven't discussed sexual abuse yet, go figure...).

I also said specifically to my CBT counsellor that I didn't want to go into the ins and outs of my childhood etc, I just wanted to stop feeling like shit. But she insisted that giving me an arsenal of tools would not be useful, so it felt a bit directionless to me. I don't know if this was her being crap at CBT, or if she just didn't think CBT was appropriate but I can appreciate where she was coming from.

So , I don't know much about the theories nor can I give you an expert opinion, but having been through it I feel CBT first and psychotherapy after has worked for me, albeit in a bit of a messy way.

Hey op

The thing about therapy is that it can get worse before it gets better.

The thing about CBT is it can only be a sticking plaster or short term gain. If the true underlying problem or issue isn't addresses then it will still continue to trigger you in the future. I'm a little concerned that after 18 months of therapy you still have not felt able to go deeper as they say and confront those demons. It maybe that your not ready or ever will be, or you need a therapist that covers everything or is what we call integrated.

My core training is psychodynamic, but also trained in CBT and other techniques, with other training I can draw on if need be.

I forgot to add, it's always ok and expected for you as the client to challenge the therapist if you are not sure of any aspect of her work, or anything she says.

Psychotherapy is more in depth. I'm not sure how effective CBT would be for something as serious as rape and abuse. And you only get 12 sessions on the NHS. CBT therapists may not be experienced at dealing with abuse, generally they're used to anxiety, depression, panic attacks etc.

CBT is quite formulaic, they dole out sheets with questions that you have to score yourself from 0-10.

Thanks for all the replies. Ideally I would go privately and see someone that could offer more than one approach. The therapist I was seeing did this but I can no longer afford to see her. It was really helpful and she got me out of a very dark place and to the point of asking my husband to leave, but then I had to stop at the point where she said I needed the most support. Turns out she was right! But at the same time I felt that I had stopped making progress so when I was given the choice of either CBT or counselling on the NHS I wondered if I should perhaps try something different. I'm still not sure!

I'm doing CBT about my rape. Having said that, this is combined with other things too and not too prescriptive or scripted.

I found it very frustrating to start with because it started with my thoughts and attitudes and reactions to the present. I thought it was a waste of time.

I knew that for me, I'd have to talk about what happened and then try to come to terms with it.

My breakthrough came when I talked through the rape. I had to record it. I had to do it in the first person as if i was seeing it now, rather than talking about the past. I then had to listen to it every day.

It's like a switch has been switched. I finally got that emotional connection between logically knowing it wasn't my fault in the slightest and actually feeling it.

The things I had issues with I realised weren't issues any more. I was raped, he didn't get get carried away, I didn't lead him on, it wasn't my fault for not realizing what he was or preventing it, I could not have reported to prevent others as I didn't see it as rape at the time (only really see it as that now), it's normal to say the right things and not feel it!

More than that, having already done the work on who I am now, I got to know the therapist and like and trust her so I could open up. I can see how how I behave now has been shaped by what I thought had happened and how I can stop a lot of it because it's not relevant to what I now know happened.

I've already been referred on for an additional course on the NHS as the max number of CBT sessions was never going to be enough. I'm glad, I was worried that'd be it but I'd have privately funded if it was.

Sounds like it has been very helpful for you Joysmum. Recording yourself talking about it and listening to it every day sounds horribly hard, but I guess there is hard work to be done to get past it. It is good to know that you can be referred for more NHS sessions if needed, I was worried that it might just stop as I started to make some progress. Wish I didn't have to wait for an appointment as I just want to get on with it now.

Oh yes it was, but it was something that was built towards. I knew it'd have to hurt and get worse before it got better, but it has got better. I can even sit and not have to have at least 2 things on the go and in the past week I've learnt I can go to sleep without earbuds in and podcasts on. I can do silence and don't always have to be on the go for distraction now

That's great! So pleased it has helped you so much. I will prepare myself for it to be tough going, but if it helps it will be worth it.