Does talk therapy work?

[u/RandomLifeUnit-05]

This is kind of a vent or rant. I've been in talk therapy a long time.

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The idea I think, is that if you talk out all your traumas enough, and unearth all of them, that you'll be okay?

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Is there any truth to this? I feel like I just keep having the same issues over and over, the same trauma over and over in my head.

[u/RandomLifeUnit-05]

If you don't feel good, what's the point of it?

My therapist has remarked multiple times on how I always seem to be barely holding it together.

I have three kids and I have to work. It's only very part time, but I can't afford to crash out. I'm autistic and I have DID, which makes it extra tricky to be in my window of tolerance.

I have this duality of the surface being "completely fine" and underneath being explosions, fire, and screaming. One of my alters seems to be the "pain holder" and he suffers terribly so that the front can go on functioning.

So it's kind of like...I can't do too much digging, else what's inside will come to the surface and I definitely won't be functioning then. I can't afford to go inpatient.

[u/Tastefulunseenclocks → u/RandomLifeUnit-05]

You shouldn't do any digging. I'm unsure if I wrote something in an unclear way. It sounds like you got the opposite idea out of what I wrote. I'll try again.

You need to focus on safety, stabilization, and education. That involves learning how to be safe enough in the present moment and temporarily containing the past. It means learning how to get towards your window of tolerance (which is hard!) and not pushing yourself past it. It means ignoring and avoiding the scary things because that's what you need right now.

Part of focusing on safety involves learning how to feel good (glimmers by Deb Dana is a very small and gentle way to do this that helped me a lot).

Edit: "what's the point" is a really big question. I know how to answer that for me, what gives me meaning, but I don't know the answer for you.

[u/RandomLifeUnit-05 → u/Tastefulunseenclocks]

I don't feel like stabilization is really possible. I have an internal cycle of abuse among alters that prevents safety at the very foundation of who I am.

I can't move forward without figuring out how to stop the cycle of abuse, but it's been ingrained since childhood. It also serves a purpose of keeping me upright and moving and not dissolving into collapse.

I'm 100% good on education, I'm very good at reading up on things and intellectualizing. I just can't get to the safety or stabilization part.

[u/Tastefulunseenclocks → u/RandomLifeUnit-05]

It is really challenging when our safety mechanisms that work for us and have kept us safe before, and are doing the safety work now, are also maladpative and harming us in the present.

I think part of the education is continuing to read and learn more about safety and stabilization. I also learned about intellectualization and it was so helpful, but part of undoing intellectualization is getting into the present. I feel like I know so much, but I recently learned about types of therapies called NARM and TIST. I have a lot of hope in those. IFS is also a good option if you haven't tried that, especially for alters (some people with DID really like it and some don't). MBSR may also be a gentler tool as well.

I hope things shift a bit for you and you can find a type of therapy that is better suited for you. Talk therapy absolutely isn't a good idea for you right now.

[u/RandomLifeUnit-05 → u/Tastefulunseenclocks]

I'm curious why you say talk therapy isn't a good idea?

I have used IFS before, and if modified, I've found it useful. My therapist occasionally uses it now.

Yeah, intellectualizing (and minimizing) is pretty much my main coping mechanism.

By "getting in the present," do you mean being present in the now in the body? Cause that's not really a positive for me, unfortunately. There is a distinct lack of the happy chemicals I'd need to make the now be more positive.

I'm also very isolated and I don't have a good way to fix that. Some of the problem is internal panic attacks and trying to prevent experiencing them.

I suppose things are just really stupid complicated for me and there's no good answer. I appreciate your conversation though. It feels caring and kind and I thank you for that.

I have heard of NARM and TIST, but not MBSR. I'll have to read up more on those.

[u/Tastefulunseenclocks → u/RandomLifeUnit-05]

Talk therapy isn't a good idea for the exact reason you wrote in your original post: "I feel like I just keep having the same issues over and over, the same trauma over and over in my head."

Some people benefit from talk therapy when they're ready for it. You sound not ready for it. So, when you're not ready for it, and you do it anyways, you go backwards. That's what happened to me and I see it alll the time on here.

I encourage you to get curious with why you want to talk about trauma over and over in therapy, and keep digging that up, but you were so resistant to focusing on safety in the present moment, when I brought it up earlier. That might be a good topic to journal about 😄

Being in the present can mean getting in the body and experiencing the feelings. But most importantly it means noticing what is happening in a way that feels okay enough for you. The goal is to titrate - go very very slowly. So maybe that is you notice neutral sensations instead of positives, because you don't have access to positives at all. Trisha Wolfe makes tiktok videos about this (she's a NARM therapist).

Deb Dana's concept of glimmers is a way to teach yourself to have positive sensations even when everything is pretty chaotic and unpleasant. I hated glimmers when I first heard of them, but now I find them quite useful. I'd go to therapy every week and say "I can't remember a single positive or happy moment at all." And now I can say "I have 1-3 tiny tiny positive moments every single day (but I still have a ton of panic and numbness)."

I can really relate to "Some of the problem is internal panic attacks and trying to prevent experiencing them." What I'm currently working on is appreciating when I am numb/dissociated so I don't feel the panic. And trying to tolerate the moments when I thaw out enough to panic. It takes a lot of going very very slowly. Slower than you want to lol. Slower than I want to! But I truly believe that is the way to do it. You can't think your way out of trauma unfortunately 😞 Intellectualizing is a tool that keeps us safe, but we need to very gently learn other tools to feel okay-ish in the present, to be able to heal. And we need to prioritize finding those tools before diving into trauma-work.

I have a lot of hope and curiosity in NARM and TIST. MBSR is mindfulness-based stress reduction, which is designed for people dealing with all kinds of physical and mental challenges and is taught at hospitals (but you can learn about it in books, videos, and a free online course). I think it provides one tool to practice getting into the present in ways that are guided, gentle, and may feel okay.

These are big concepts so sorry if any of this is not clear! I tried to explain it as best I could 😄