Trauma therapy suggestions (Boston)
January 2, 2019 7:52 AM Subscribe
As I enter the new year I'm ready to shed some of the persistent after-effects of traumas I experienced in 2015. Looking for recommendations for 1) specifically trauma-oriented therapists in the downtown Boston area, 2) advice about continuing talk therapy, and 3) modality suggestions. Snowflakes inside.
Background: In 2015 I dealt with a number of bizarre convergence of near death experiences and other assorted traumatic incidents. I've been in various therapies and personal improvement courses since early 2016. I've been able to achieve a lot since then on paper, and am proud of the way I've been able to bounce back (job, housing, social life etc.), but It's come to my attention recently that:
1) I occasionally still get violently triggered (extreme muscle tension and anxiety) when I experience certain jerky movements in vehicles (related to a car accident from 2015)
2) it's hard for me to separate out the various traumas that happened within a short amount of time that year, and some of my coping mechanisms do more harm than good (ex. trying to control everything in my life as a catch-all) - leaving me with an overall feeling that death is always around the corner and I'll never accomplish enough in the time I have left. (NB: the doom feeling is external - no self harm tendencies).
The impetus: 2 weeks ago I experienced two coincidental triggering episodes in cars that were very upsetting both in the moment, and have left me feeling drained, and raw, and a bit emotionally unstable since then - it feels like those 2 incidents sort of "shook loose" some of the buried trauma.
My ideal therapist: Ideally someone who could address both the moving vehicle trigger responses, and the general doom feeling, in a relatively short amount of time. (I mention the amt of time because I have been "working on myself" basically nonstop since early 2016, and have a lot of ways that I am able to express myself currently - so I'm looking now more for results than more support, if that makes sense).
Demographics: 29/F. Open to any gender identity and modality of therapist. The 3 Boston areas that would be most workable for me would be Somerville, Back Bay, and Roslindale. I am currently seeing a talk therapist for general anxiety 1-2x a month - she does not specialize in trauma therapy, and while I like her a lot so far (I've been to 3 appts so far) I don't know if it's getting to the root of getting rid of the trauma aftereffects. I haven't seen her since the 2 triggering episodes, I've put in a call to her to ask her thoughts about pursuing trauma therapy additionally but haven't heard back yet. So in the meantime:
Questions:
• Do you know any really excellent trauma-specific therapists in the Boston area? I'm not interested in generalists. I'd be willing to go a bit outside of Somerville/Back Bay/Roslindale if it means I'm getting the best results.
• Do you have advice for whether I should continue my talk therapy for general anxiety, while seeing a separate trauma therapist?
• Any recommendations for specific modalities (EMDR, exposure, etc.) that you know personally are effective for this type of trauma?
thank you in advance!
Background: In 2015 I dealt with a number of bizarre convergence of near death experiences and other assorted traumatic incidents. I've been in various therapies and personal improvement courses since early 2016. I've been able to achieve a lot since then on paper, and am proud of the way I've been able to bounce back (job, housing, social life etc.), but It's come to my attention recently that:
1) I occasionally still get violently triggered (extreme muscle tension and anxiety) when I experience certain jerky movements in vehicles (related to a car accident from 2015)
2) it's hard for me to separate out the various traumas that happened within a short amount of time that year, and some of my coping mechanisms do more harm than good (ex. trying to control everything in my life as a catch-all) - leaving me with an overall feeling that death is always around the corner and I'll never accomplish enough in the time I have left. (NB: the doom feeling is external - no self harm tendencies).
The impetus: 2 weeks ago I experienced two coincidental triggering episodes in cars that were very upsetting both in the moment, and have left me feeling drained, and raw, and a bit emotionally unstable since then - it feels like those 2 incidents sort of "shook loose" some of the buried trauma.
My ideal therapist: Ideally someone who could address both the moving vehicle trigger responses, and the general doom feeling, in a relatively short amount of time. (I mention the amt of time because I have been "working on myself" basically nonstop since early 2016, and have a lot of ways that I am able to express myself currently - so I'm looking now more for results than more support, if that makes sense).
Demographics: 29/F. Open to any gender identity and modality of therapist. The 3 Boston areas that would be most workable for me would be Somerville, Back Bay, and Roslindale. I am currently seeing a talk therapist for general anxiety 1-2x a month - she does not specialize in trauma therapy, and while I like her a lot so far (I've been to 3 appts so far) I don't know if it's getting to the root of getting rid of the trauma aftereffects. I haven't seen her since the 2 triggering episodes, I've put in a call to her to ask her thoughts about pursuing trauma therapy additionally but haven't heard back yet. So in the meantime:
Questions:
• Do you know any really excellent trauma-specific therapists in the Boston area? I'm not interested in generalists. I'd be willing to go a bit outside of Somerville/Back Bay/Roslindale if it means I'm getting the best results.
• Do you have advice for whether I should continue my talk therapy for general anxiety, while seeing a separate trauma therapist?
• Any recommendations for specific modalities (EMDR, exposure, etc.) that you know personally are effective for this type of trauma?
thank you in advance!
Hi! I probably have some names to recommend (memail me if interested in those) but generally speaking: You sound like an excellent candidate for trauma-focused therapy, which is currently the most evidence-based form of trauma treatment. Two particular TYPES of trauma-focused therapy that are especially well-established are Prolonged Exposure (PE) or Cognitive Processing Therapy (CPT). These both involve exposure (as do almost all effective forms of psychotherapy for fear-based disorders). EMDR also involves exposure and is currently a recommended treatment (I am a psychologist with extensive background in anxiety and trauma and I think that the eye movement thing is hokey and overblown, but you still get the meat of the effect through the exposure elements of the treatment).
Good news/bad news: There are LOTS of therapists in the Boston area. Unfortunately, it is SO SO easy to say you "specialize" in trauma and then.....just chitchat about stress with your patients once a week for 5 years. For $200 a session. PLEASE ask further questions. You want someone who will be asking you to describe your trauma experience in detail, repeatedly (there may be some necessary prep work to get to this place, but that will be on the order of weeks not months). Ask if this therapist has attended a CPT or PE training. Have they done a rotation/fellowship through some of the best training facilities locally, like the Center for Anxiety and Related Disorders at Boston University, or VA Boston?
Good luck to you!
posted by Bebo at 9:01 AM on January 2, 2019 [3 favorites]
Good news/bad news: There are LOTS of therapists in the Boston area. Unfortunately, it is SO SO easy to say you "specialize" in trauma and then.....just chitchat about stress with your patients once a week for 5 years. For $200 a session. PLEASE ask further questions. You want someone who will be asking you to describe your trauma experience in detail, repeatedly (there may be some necessary prep work to get to this place, but that will be on the order of weeks not months). Ask if this therapist has attended a CPT or PE training. Have they done a rotation/fellowship through some of the best training facilities locally, like the Center for Anxiety and Related Disorders at Boston University, or VA Boston?
Good luck to you!
posted by Bebo at 9:01 AM on January 2, 2019 [3 favorites]
I highly recommend EMDR, which helped me greatly when dealing with trauma aftermath. In particular, I think your understanding of the specific situations that trigger you are helpful because one of the things you do in EMDR is find and remember a traumatic memory.
I will say that I worked in an office with lots of therapists who really poo-poohed EMDR so I went in really skeptical, but found it to be transformative - and overall just helpful really quickly. Like I could go back into my day and notice things feeling different right away.
Good luck!
posted by fleecy socks at 9:02 AM on January 2, 2019 [2 favorites]
I will say that I worked in an office with lots of therapists who really poo-poohed EMDR so I went in really skeptical, but found it to be transformative - and overall just helpful really quickly. Like I could go back into my day and notice things feeling different right away.
Good luck!
posted by fleecy socks at 9:02 AM on January 2, 2019 [2 favorites]
CPT provider roster.
Mind that you will not be asked to repeat your experience continuously in CPT, but will be asked to examine your beliefs and your thinking in detail. PTSD treatments that I am familiar with, CPT and PE, are effective, short-term and very difficult to engage in, because of the avoidance that is inherent in PTSD maintenance. It's great that you want to address this head on, motivation is really key here.
Do not see two therapists at the same time, and do not keep a "non-trauma" therapist on stand-by as you attempt to complete PTSD treatment. It may be too tempting to go back to the supportive "easier" therapy.
I personally like CPT because it engages our thoughts about ourselves and the world, not just exposure. There are not many people who provide it outside of the VA (I think many people trained in it do not end up regularly practicing and don't end up on provider roster). PE is the other gold standard. Because you have discreet traumatic experiences that resulted in flashbacks and hypervigilance (need to control your environment) I think that therapies such as Internal Family Systems and STAIR that are aimed at complex trauma may not be as effective.
posted by Shusha at 6:54 PM on January 4, 2019 [1 favorite]
Mind that you will not be asked to repeat your experience continuously in CPT, but will be asked to examine your beliefs and your thinking in detail. PTSD treatments that I am familiar with, CPT and PE, are effective, short-term and very difficult to engage in, because of the avoidance that is inherent in PTSD maintenance. It's great that you want to address this head on, motivation is really key here.
Do not see two therapists at the same time, and do not keep a "non-trauma" therapist on stand-by as you attempt to complete PTSD treatment. It may be too tempting to go back to the supportive "easier" therapy.
I personally like CPT because it engages our thoughts about ourselves and the world, not just exposure. There are not many people who provide it outside of the VA (I think many people trained in it do not end up regularly practicing and don't end up on provider roster). PE is the other gold standard. Because you have discreet traumatic experiences that resulted in flashbacks and hypervigilance (need to control your environment) I think that therapies such as Internal Family Systems and STAIR that are aimed at complex trauma may not be as effective.
posted by Shusha at 6:54 PM on January 4, 2019 [1 favorite]
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posted by FencingGal at 8:25 AM on January 2, 2019 [2 favorites]