How do I overcome trauma / PTSD / depression / learning-disabilities?
August 10, 2017 10:04 AM   Subscribe

I have a childhood history of sexual abuse (non-family member) and psychological, emotional, and physical abuse and domestic violence (from family). I need to move on. What can I do?

Hi everyone,

So, I thought that after 8~ years or so of CBT with an amazing therapist I would be all set to go moving forward with my life. I did a lot of work on myself during that time, made a lot of advancements, and I am proud of what I was able to accomplish (graduated from an excellent school, worked internationally, traveled, learned some languages, dated some rad people, made friends, etc). However, I am still dealing with a handful of disturbing symptoms that I *need* to overcome.

The short version:
Grew up in a violent household with alcoholic father and NPD/ bipolar mother, both of whom physically and emotionally abused my siblings and I, abandoned us for months at a time, called us names, locked us in closets, threw things at us, kicked us out, gave me a black eye, denied us food, blamed us for their problems, dropped my sister and I off on the side of the highway in the middle of a distant state and drove off, stole from us (all college "savings" I was supposed to have built up from birthday checks over the years, stuff like that), etc. The list goes on. Extra-family situation: friend's father raped me at age 14, brainwashed me for several years, abused me emotionally, 'mind-control' type stuff (like building up my self esteem only to rip it down to control me, etc). I put this person in prison a few years back completely of my own volition. My mom knows about it now. My dad does not.

Fast forward to the present / symptoms:

Basically, I don't lack for smarts or motivation, but I disassociate a lot and experience unbelievable, sporadic body pain. I am taking medication (bupropion) and I am in the process of lining up an EMDR therapist and an additional ongoing talk therapist. I also set up an appointment with a rheumatologist for December (earliest available) to rule out any kind of autoimmune disease. I got blood work done earlier in the week and everything came out fine, thankfully. On the other hand, not having a treatable disease means I have to foray further into other possibilities.
-extreme body pain: this is like burning, tingling, crushing pressure, numbness in my legs, feet, and travels through my whole body but is mostly from my hips down.
-spontaneous over-reactive stress from normal things, such as school work and work (I'm a waitress) puts me into pain and my brain like, overrides a rational response to these stressors. Like I know I should not be having a severe stress response to daily life stressors, but I just am and I need to figure out how I can get out of this.
I don't feel depressed in the classic sense, usually, but the body pain starts up a cycle of 'this is hopeless; how can I do anything while my body is aching like fire.' I am actually a pretty positive person most times. And I still have dreams and goals. But this is not letting me move forward. I take dance, eat well, don't drink or do drugs, hang out with friends, drink lots of water, sleep 8 hours, meditate, take bupropion, etc.

It seems like my body, brain, and emotions are not integrated. I've worked really hard to heal but there is a long way to go, as well.

This is holding back my life. I can't move forward with grad school stuff if this continues as I am not able to learn despite my best efforts; I have not been able to find or secure any job that puts me above the 12k a year income bracket, and I have not been able to climb out of my student debt.

What are some ways to deal with this? Has anyone had success with EMDR therapy? Am I doing something wrong that could be exacerbating this? Is this actually depression or PTSD related? Can this be overcome? I mean I am asking every single question that comes to mind because I just don't even know where to start with this.

Thank you for your consideration.
posted by erattacorrige to Health & Fitness (15 answers total) 6 users marked this as a favorite
Trauma focused dialectical behavior therapy.

Designed for a very specific condition, peer reviewed and replicated as helpful to folks with trauma history.

You can also look into Bessel van der Kolk's work on developmental trauma disorder, which is itself not actually (yet, I have hope) in the DSM. He's one of the people who fought to get it's in the DSM.
posted by bilabial at 10:13 AM on August 10, 2017 [5 favorites]

The Body Knows the Score is about exactly this and discusses research and treatments; EMDR is one of several treatments the author has seen help people.
posted by songs about trains at 10:29 AM on August 10, 2017 [6 favorites]

I apologize if this isn't practical, but have you considered looking for work other than waitressing? I know that doesn't address the larger problem of your response to pain, but it could make it a less urgent issue, give you more time to sort it out, and make it easier for you to put your energy towards succeeding at school.
posted by bunderful at 11:40 AM on August 10, 2017 [2 favorites]

re dissociation, have you and your therapist used this book? -heard really good things about it.

im so sorry about what they did to you, and at the same time im so blown away by your resilience. keep kicking butt!
posted by speakeasy at 2:04 PM on August 10, 2017 [1 favorite]

I also came to suggest reading "The Body Keeps the Score". It's been a healing read for me, and helped me intellectually understand why my body is different than other peoples'. Because of childhood trauma I am 'hardwired' differently. It's put me on a path to being able to make choices that are physically right for me without application to what works for others. And it's helped me understand why, when I felt like I had worked so hard and so long and had healed on so many fronts, certain issues lingered.
posted by AliceBlue at 2:06 PM on August 10, 2017 [4 favorites]

Nthing The Body Knows the Score. That and EMDR changed my life.

EMDR significantly improved my PTSD, almost like turning down the volume and intensity of my reactions. Yes, I still live with PTSD - you can't erase the past - but it is so so much more manageable now.

Reading Body Knows the Score really helped me get to grips with the nature of PTSD, suggested potential things I could implement, and fundamentally helped me to understand what PTSD is and does. As a result, triggers and so forth have become that much more manageable. I also appreciate the way the author breaks down the concrete physiological elements of PTSD, and discusses different cases, demonstrating that a lot of people go through this stuff.
posted by thetarium at 2:08 PM on August 10, 2017 [3 favorites]

I don't think you are doing anything wrong and I think you are doing many things right. I've had EMDR therapy, and I found it really useful. I found that it just made everything a bit less intense, so I could think things through properly if that makes any sense.
posted by Nilehorse at 2:28 PM on August 10, 2017 [1 favorite]

I'm a clinical psychologist who specializes in trauma treatment and does research on trauma recovery. Most of my work focuses on recovery from sexual victimization. Although there is no one-size-fits-all solution, I strongly recommend Cognitive Processing Therapy or Prolonged Exposure as first-line options given that they have a lot of evidence for their effectiveness in treating PTSD in ~12 sessions with lasting effects, and tend to be delivered reliably in the community. They are the most reliably efficient/effective option, in my research and clinical experience. EMDR is effective if delivered as designed, but I hear very regularly that it is delivered in other ways that are untested and likely to be ineffective- you should not be in it for years, for example, and the therapist should not switch to only using the eye movements/taps (rather than also having you focus on/talk about the trauma) in response to your distress. If you can only find an EMDR therapist, make sure that they are committed to giving you the treatment in a time-limited fashion. PTSD is a *very* treatable disorder- so I hope that gives you some hope for getting through this.
posted by quiet coyote at 2:51 PM on August 10, 2017 [4 favorites]

I think you need to see another doctor. Pain like that likely had a physical cause. Have you had an MRI? Or lower back xrays? Blood work isn't much of a workup for a young person in that much pain.

Your question reads a bit like you feel the pain is almost your fault for not succeeding well enough at therapy. I suggest you take that burden off yourself and get thee to a doctor who takes your physical symptoms seriously and seperate from your emotions. People with emotional trauma still deserve medical care.
posted by fshgrl at 6:26 PM on August 10, 2017 [4 favorites]

This sounds like the exact kind of pain that people get prescribed Lyrica or gabapentin for. I had Lyrica pushed at me for another sort of chronic pain with a clear physical cause, read up on it, and said a hard Fuck No to trying it; you may have already done the same, or tried it and had no success. but if the person prescribing the bupropion is not also your therapist and is not aware of these physical symptoms, bring it up with them and see what they suggest.

there are also a million good reasons you might be taking bupropion rather than another antidepressant. but if you haven't already gone through a few rounds of trials of different ones, there are some antidepressants that are also prescribed for "nerve pain" of unknown origin that might be worth a shot.
posted by queenofbithynia at 9:32 PM on August 10, 2017 [1 favorite]

Hey, thanks for the thoughtful replies; I have actually read The Body Keeps the Score by van der Kolk and it was totally life changing, because it at least gave me a vocabulary for these issues and made me feel like I am not crazy.

I guess I should investigate these other options- Lyrica, exposure-based therapy- I've read about gabapentin and it actually apparently doesn't negatively interact with bupropion but it seems a bit scary as a drug.

Thanks for those who told tale of their own positive EMDR experiences.

Still fielding thoughts, should there be more....
posted by erattacorrige at 9:53 PM on August 10, 2017

Complex PTSD statistically makes adults way higher risk for a lot of diseases (thanks parents!) the current theory I think being that your child immune and nervous system was in a constant overdrive and the damage cascades. It helps to reframe this as you need more healthcare like someone who went through a serious illness in infancy, so you need extra flu shots, multivitamins, have to do yoga and swimming and eat extra well etc. All that sleep eight hours etc is baseline for you, not indulgent because you are at risk.

The physical work up is a really good idea. I had awful migraines since I was a child and small TIAs (blood clot temporary strokes) for about 3 years before diagnosis, and it took another couple of years to get an actual treatment plan stabilised that I'm mostly at school part time, working part-time and parenting full time. If you have something weird and immune related, and unfortunately if you're female and have any psych record this can make the search harder, it can take a while to get an answer. Especially with pain.

There are non-medical ways to manage pain. I would look into chronic illness pain management like ice packs, heat packs, massage (self massage techniques, trading with a friend), aromatherapy works for some, body pillow for sleep posture, yoga, breathing techniques etc. It's very individual and going through each option slowly and deliberately could help you feel in control. Keep a symptom journal to see if there's a pattern in triggers, stress or places. I found fluorescent lights and lack of sleep, but no food triggers, for example.

If you can see a neurologist and/or a pain specialist, I would pursue those now. You don't have to be in pain and you can't get better through willpower alone. You wouldn't expect a child to climb a mountain over broken glass, so why are you making yourself do that?
posted by dorothyisunderwood at 10:09 PM on August 10, 2017 [4 favorites]

if you are looking for a non drug and non invasive option try getting John F Barnes Myofascial Release Therapy. it is a form of manual therapy that you can get from a licensed massage therapist, a physical therapist, occupational therapist, or a nurse.

i am using this technique with someone who was raised by a cluster B parent & enabler in an abusive household and has had lifelong pain/health issues, while he is working with another trauma therapist who does more talking-oriented stuff. he had to suppress his emotions and opinions heavily to survive in the household he grew up in, among other harmful dynamics. after about four or five sessions he unwound on the table and cried for a couple of days and stated that it was "by far the most intense/immediately effective therapy both physiologically and emotionally" that he had ever experienced (has been to about 9 talk therapists previously, but never had EMDR). the more we work together, the faster he responds and the deeper sense of peace he feels. he had been unable to cry or express anger for years and stated that he felt a lot of relief at that leaving his body.

emotional trauma can cause fascial restrictions, and that scarring can cause all kinds of health problems, from chronic pain to neurological issues to postural distortions to organ dysfunction. every cell, organ, muscle, nerve in your body is wrapped in fascia. it is all one incredibly complex organ. it connects and holds together everything in our body. when you're in a physical accident, sustain an injury, or experience emotional/psychological trauma, fascia will solidify and scar over and impair normal and healthy function. the longer the scars are there, the more they impair normal function. myofascial release is when a therapist applies gentle, sustained pressure or traction, and waits several minutes until the tissue relaxes and unwinds itself and becomes fluid and normal again. you will know it is working because you will FEEL IT, right away. recent research is suggesting that fascia conducts energy and moves fluid/hydration/hormones/nutrition throughout the body, making it essential to health. previously the medical community thought of it as "packing material", just connective tissue. but the more we study it in living people the more we see that's wrong.

i am not suggesting that you should do this instead of seeing a doctor or trying medication, but i am asking you to consider trying it first because it is so gentle and does not have side effects like strong medications do. PM me if you want a recommendation for an experienced provider near where you live.
posted by zdravo at 10:44 PM on August 10, 2017 [3 favorites]

In addition to the Body Keeps the Score, which is marvelous, the works of Peter Levine, Healing Trauma and Waking the Tiger have been very helpful for me. Especially around pain. Wishing you healing.
posted by Sophie1 at 7:27 AM on August 11, 2017 [1 favorite]

I'd definitely, definitely get a diagnosis from someone you trust before taking anything like lyrica or gabapentin. Those have hard core side effects. I have painful nerve damage from an old injury and won't even consider them. Same with things like epidural steroid shots, the risk of side effects is so incredibly high and there is no proof they work. Focus on a diagnosis for the pain, then treat with drugs or surgery only if you have to.

In the meantime support yourself, invest in yourself. Rolfing, myocardial release, nutritional support (I take a multivitamin morning and night because I have celiac- huge difference) exercise, weight control, a really good diet (which is hard when you work a lot I know but you can easily do things like cut out sugar), being careful of your exposure to known if mildly toxic chemicals (I won't ever use oil paint again or allow perfumed products in the house), comfortable bed and time with friends and to just relax are all important All that stuff just gives your body some help. It's not a cure-all despite the internet claims but it adds up. Rest more, eat better and laugh longer.
posted by fshgrl at 9:05 PM on August 11, 2017 [1 favorite]

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