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TherapistMarryAnn, Therapist
Category: Mental Health
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Experience:  Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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Kate. The thread is now "locked" - so thank you. I don't

Resolved Question:

Hi Kate. The thread is now "locked" - so thank you.
I don't think it is necessary for anyone else to know. The only reason I wanted to tell my minister/friend when my therapist suggested I tell someone the details, is because he already knew that something happened, he could give me a Biblical perspective, and I needed him to understand that I was not just an innocent victim -- that I participated. Also, it would be nice getting a guy's perspective. But, as I said, now I am sorry I did.
And yes -- my therapist told me I had PTSD when I first met with her. I guess because of the replaying nightmares and the increased startle response. But she told me how different it seemed that I didn't have some of the other common symptoms, and apparently never had. Of course, now I have most of them... My pdychiatrist agreed and I am on zoloft for the PTSD. She also put me on Wellbutrin for ADD (which I had no clue I had until recently - my primary asked me about it. butboy does it make a huge difference. Wish I would have known earlire), and doxepin to help with sleep/nightmares. I am going to call her today and seee if there is something else I can take to help me sleep or to make me feel better right now.
I don't feel "stuck" in therapy. It's just that I'm having a hard time right now and I have to act like everything is fine everywhere else, and I can let my guard down in there. But I don't want to start sobbing or something, so I sit there going over things in my head as she's asking me questions, trying not to cry, and she either sits and watches me or just looks down, after handing me tissues. I don't know what it is I want her to do, but it is just awkward and uncomfortable, even though I feel comfortable with her generally. We were just about to start EMDR (we had done a pretty benign practice run) when all this othercrap hit, so I think we'll get back to that. Otherwise, I think she's at a loss as to what to do right now. She wants me to take several days off, which I can't. She told me last night that it is difficult for her to watch me struggle and that I seem so sad. okay, but I want it to stop. I want her to wave her magic wand and make it go away.
She told me this morning that, with my permission, she'd like to talk my situation over with the director of the counseling center. (I think she called it "staffing it out" or something). I told her to have at it. If somebody can figure out something, that would be great. But I can't go even the rest of the week getting an hour or two of sleep and still function.
Oh well.
Thanks for your help.
Submitted: 5 years ago.
Category: Mental Health
Expert:  TherapistMarryAnn replied 5 years ago.

I am glad the moderators were able to help you to close your question. They did it so quickly that I was worried that you did not get a chance to read my response to you! But I'm glad you were able to see it.

It's good that you are familiar with PTSD and you are being treated for it. I cannot imagine that you would not have at least some of the symptoms, even before your break through. But you mentioned that now you have most of the symptoms, which cannot be easy. What do you feel are your most prominent symptoms? You mentioned nightmares and trouble sleeping and tearfulness already. What else are you coping with?

It's good that your psychiatrist found the ADD. Sometimes it is hard to discover these issues when there are other problems like PTSD there already. Symptoms become mixed up and separating them is more difficult.

You talked about not wanting to sob in therapy. I was wondering what you feel would happen if you did sob?

I can understand you wanting your therapist to have a magic wand and use it to help you. I think all therapists wish they had one too! I know I certainly do. It is hard to see someone in such pain. I think one of the important things to explore with how you feel is where you feel your tears and sadness are coming from. Besides the obvious, what are some of the deeper reasons for your tears? Is it about loss, pain, or loneliness (survivors often feel they are alone because of what happened to them). Was there something in particular about the attack that is sticking with you, that makes you feel sad?

Your nightmares can also be a source of information about what you are feeling. Writing them down and exploring what they are about can help you confront fears and other feelings associated with them.

It sounds like your therapist wants a consult with her director. It's a good sign that she is looking for other options she can use to help you. It is common to discuss cases among therapists so you can be sure you don't miss anything and are doing all you can to help.


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Customer: replied 5 years ago.


As far as the PTSD symptoms now -- well, I've had the nightmares for years. The "new" things are that these visuals of parts of what happened run through my head in the daytime now. That's not brand new. That started a few months ago. And then sometimes it's not visual things, but just thoughts or feelings. I don't really know what the feelings are, but I know they're linked to that. And, I told you that things like men touching me or guys walking by my car put me into a kind of "alert" mode, which is brand new. Sometimes, when we are talking about some specific part in therapy, I almost feel like it's happening and a few times, I even felt pain, which is kind of freaky. Most of all -- I am just thinking about it, in one way or another, all the time now. It's becoming an unhealthy obsession, I feel. It's like I'm fixated on it right now (a good example of this is that I am chatting with you between appointments instead of getting my work done). This week it is taking so much effort just to come to work, meet with people, etc. and not cry. On Friday, I about flipped out because the mug from which I drink my coffee every morning, that I've used for over 10 years, has cracks in it. It was from my dad's bank, so I had to call him and ask him to send me another one. I told him I had to have one, but he said they didn't have them anymore. Fortunately, one of his VPs had one in her office and said I could have it. Now --- I realized afterwards that this was ridiculous (and of course my dad told me it was strange and ridiculous -- but all the same, he's sending it to me). So I am clearly overreacting to things. Also, I have absolutely no desire to be around anyone, and I am exhausted from acting like everything is great. I sing in our praise band at church (and play the drums sometimes), and I just told them I'm not coming for the next few weeks and that they needed to have someone fill in for me. I find myself purposely baiting and pissing off my friends. My best friend (who I live with - she's the nicest person you'd ever meet -- 25 years older than me and we get along great) -- I haven't been pissing her off, because her dad is on hospice dying, and her mom just died 5 months ago, so I have to make sure she doesn't see anything wrong, because she is dealing with a ton and she needs to lean on me. So I can't talk to her about any of this right now. It wouldn't be fair. But that also requires me to be around people, when I help out with her dad. But I really pissed off our music minister (the friend I told the whole thing to), and I realized that I did it on purpose. I wanted him to be pissed at me so I could have some reason to be pissed at him. Now, is that dumb or what?

I'm just not used to all these things. I feel like I'm out of control. I want to go back to when it was all tucked away and back to the numbness, but I can't seem to do it. I need to get some solid footing here really shortly. I cannot stand not being in control. I think a lot of it is that I'm so tired from not sleeping and so tired from having to act like everything is great.

About hte ADD - yeah. I was glad about that. My primary asked me about it - but I was having concentration problems because of what's going on. I thought it was ridiculous, but when I mentioned it to my best friend, who was a teacher, she said "well...." and we looked it up. I didn't think I could have gotten through law school with ADD. It just never dawned on me. But I read some stuff by ADD lawyers explaining how they felt and a lot of it was exactly like me. I keep lists and calendars almost neurotically, and I think that's how I compensated. My therapist gave me a test thing, andI took it to the psychiatrist. At first, the wellbutrin didn't work - but when she upped the dose, it worked right away. I couldn't believe it. It was like this haze I had in my brain (that I never knew I had) lifted. Pretty awesome. In retrospect, everything in my childhood behavior would have been a red flag nowadays, but back then, ADD wasn't really an issue.

As far as my nightmares go, as I said, I've had them forever. But now they are different. It was always re-experiencing what happened, either as though it were happening to me or watching it. But now they are changing. My therapist says that part of my problem is that she thinks my nightmares are inaccurate --- that they are out of context, in accentuating certain things and not others, and so for the last however many years, since I had blocked away the actual memories and never thought about it consciously, that I relied on my nightmares as my memories and therefore have a skewed perception of things. Makes sense, I guess.

About the sobbing -- I don't know. I really don't want to get out of control in therapy. And I don't know what she'd do. What would she do? Right now, she just puts tissues in my hand and either stares at me or looks down at her file. I'm not sure what she'd do if I lost it. I told her last evening she needed to change the subject because I was abot 60 seconds away from losing it, and she asked if I wanted to ose it, and I of course said no. Then, thankfully, my phone started making a quackng noise, which ligtened things up. And she did change the subject. She has told me it is okay to cry and that it is appropriate. I have cried in there. But I felt like I had to ask her if it was okay to cry. I didn't know whether her handing me tissues and becoming silent was her way of saying "stop crying." The first time I cried, she cried. I couldn't really tell if she was crying or had allergies, so I asked her the next time. She said she couldn't help it and apologized. But I thought it showed empathy. It was kind of nice. So - I don't know what she would do if I started sobbing. It would be awkward sobbing with someone staring at me. It's awkward enough if it happens at home by myself.

As far as the sadness - I don't know what it is. I don't know if it is even sadness. I do feel alone. Especially now because I have to hide how I'm feeling. And sometimes I feel like I'm 21 again, and after that happened, I felt so alone - the most alone I've ever felt - even though I lived in a house with 30 other girls and went to class every day with a bunch of people. I still felt really alone. So sometimes now that comes back and I feel the same. Otherwise, I don't know what I feel, except confused and out of control and angry at myself. There are a few parts of the whole thing which really bother me. I discussed them last week in therapy. They involve my offering myself to him in 2 different ways. That's something I see often.

Okay ... well I really better get some work done before my next client.

Thanks, Kate.


Customer: replied 5 years ago.
oh yeah - and I've been throwing up a lot. fun stuff!
Expert:  TherapistMarryAnn replied 5 years ago.


It makes a lot of sense that you are experiencing your emotions at such extremes. Being calm and collected is not how most people react to a trauma. And this is your time to react because your emotions are all coming to the surface.

Being angry all the time is a way to not only deal with the deeper emotions by feeling more powerful and less helpless. It also serves to keep others at a distance. If they are angry at you, they do not want to be close to you. You are probably feeling pretty raw right now and may need some distance from others. Also, anger is part of the grieving process. You had something very unfair happen to you and being angry about it is natural. Since you cannot direct your anger at the appropriate people, you direct it anywhere you can.

Letting go of the control you had over your feelings before has allowed all of these emotions let loose like a flood gate opening. It's going to feel overwhelming and it's going to take time for you to adjust. You need to allow yourself to feel what you could not feel before. By doing this you are allowing yourself to react normally to an abnormal event. You will not feel this way forever, only until you assimilate the feelings and find ways to cope with how you feel. It will become part of you but it will not define you. That is when you know you are better.

You are not fixated on yourself and your feelings. What you feel is going to take over your life for a while because it was such a traumatic event. You are supposed to be fixated on it. It is your mind's way of getting you to deal with it. It brings you back to the event over and over until you can accept the feelings and the event. Once you do, you will feel better.

It doesn't help you are not sleeping. When you don't sleep, you don't have the same emotional control that you usually have. But not sleeping is part of the PTSD. It may help you to accept that for right now, you are going to feel out of control. You are not, in reality, out of control, but you may feel like it. And that is ok. There is nothing wrong with how you feel. I have worked with people many times who felt as you do. They are never out of control but only feel that way.

It is perfectly alright to cry in therapy. It may feel awkward because you don't know how your therapist will react, but my guess is from what you said that she may cry right along with you. That might be what you are picking up from her when you start to cry. She is afraid she won't be able to hold in her feelings and be there for you. I have felt that way in therapy and I can hardly prevent myself from tearing up. Your therapist sounds compassionate and probably feels the feelings right along with you.

It is easy to feel alone after what you went through. No matter how many people you are with no one is going to understand completely how you feel. Because of this, you may want to try to reach out to rape survivor groups when you feel ready. They can offer support that no one else can.

I understand your feeling that you offered yourself to the perpetrator. You are going to feel somehow at fault for this because of the nature of the crime. But the difference of what you did and someone who voluntarily gave themselves to this criminal is vast. You did not choose to be there. You did not choose to have sex with the perpetrator. They used psychological coercion on you to get you to stay. You were trying to survive and you did what it took to be here. It may not feel that way now, but as you work through this, your feelings about what happened will change and you will be able to see it for what it was, a crime against you that you had no choice in.

You mentioned throwing up a lot. Have you seen your doctor about it? I think it can be emotional, but I think it's a good idea to rule out anything physical first.


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Customer: replied 5 years ago.

Thanks. I'm positive the throwing up is emotional. I can tell. I will take some anti-nausea stuff when it comes again, because when I throw up a bunch I sometimes end up throwing up blood for a week or two, which sucks. But I haven't been.

I left a voicemail message for my psychiatrist earlier today, kind of telling her that something "snapped" after my phone conversation with her a few weeks ago, and asking if there's anything she can give me to help me sleep (I told her I didn't care about the nightmares right now -- I just need some rest) and if there's anything that might make me function better during the days. She hasn't called me back yet, but I'm sure she will tomorrow. I see my therapist at noon tomorrow, and I'll ask her if she thinks she should call the psychiatrist to explain. She has a different take on it. I am upset that the conversation screwed things up and my therapist, although understanding of my current unhappiness, is glad. My "thanks alot" is likely to be much more sarcastic than hers. :)

I reckon that if I get as little sleep tonight as I have been getting, neither me nor my therapist will have a choice about whether I end up sobbing. Not sure whether that is good or bad, but it is what it is. My pride's out the window these few weeks anyways. And I don't care if she cries. It actually makes me feel like it is reasonable for me to cry. And it's not like she won't "be there for me" anyway -- she can sit and stare if she's crying or if she's not. It's not like I wanted to sit on her lap and for her to tell me everything's going to be okay. -- Well, actually, I would like for her to tell me it's going to be okay, even though I already I know it will be.

And I'm sure people will get over being pissed at me. Right now I don't care. And I think you're right -- it's just somebody for me to be mad at. But best for all concerned if I just stay away. You're right also that I don't want to be around anyone I don't have to be around, and I don't want people coming around me.

In other news, I came to the conclusion last night that even though I thought I felt nothing about those 2 guys, I kind of hate them. It was surprising to me to realize that. I know that I'm supposed to forgive, and I thought I had, but I guess not, after all. But I will. My therapist says it's a good thing to maybe hate them a little for now. Haven't thought it through yet, but I'm kind of mad at all of us.

Thanks again.


Expert:  TherapistMarryAnn replied 5 years ago.


It is ok that you hate the two guys who hurt you. Directing your feelings towards them is a step in the right direction. Right now, you are dealing with the most intense part of your recovery. The feelings you have are natural and need to be let out. God understands that. And you will probably eventually forgive them. But for now, letting those feelings out is healthy and will help you heal.

Anger is a natural response to your pain. Most people who have PTSD find that they are angry at themselves, the world and whoever hurt them. Anger is a normal response to being hurt. Have you ever hit your finger when you were hammering a nail in? One of the first responses is to get angry in general, then it is to blame something or yourself for missing the nail.

Anger is also part of your survival mode. Would you approach someone who is angry over someone who is crying? That anger keeps people away and it also keeps the tears away. It gives you power and a kind of strength. It makes you feel bigger than you are.

Now that you are "exposed" with your feelings, the threat of someone hurting you is all around you. You don't know where it's going to come from. Anger helps protect you from someone coming at you and hurting you. If you look dangerous through your anger, then others will stay away or think twice about bothering you.

It also helps you control your environment. If you believe that everyone is responsible for what happened to you then anger helps you confirm it. By provoking them and making them angry at you, you confirm your belief that no one cared to help you when you were hurting, even though they did not know about it.

You can help yourself with your anger. Learning to relax is the best step to take right now. When you feel angry and want to provoke, try using relaxation techniques to calm yourself. It will give you more control and help you bring out your other emotions. Here is a link to help you with relaxation techniques:

See if you can practice some of these techniques in the next few weeks. Don't put a lot of pressure on yourself but try them when you feel up to it. Once you learn them and begin to use them, they may also help you sleep better.

I'll talk with you soon,

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Customer: replied 5 years ago.
Hey Kate. You really cleared up everything about the anger. Thanks. It makes a lot of sense. And you are right. But isn't it okay to want everyone to leave me alone right now? It just makes things more difficult to deal with people. It's okay with clients or in court, and I really have no choice about that. But I don't have the energy to deal with anyone else right now. I'll be in the position to either have to act like everything is super or I may fall apart. My legal assistant, who also goes to my church, was substituting for me in praise team last night. And she called me to tell me thay people were asking her what is wrong with me and that "c," my friend/music minister who I have royally pissed off asked her what my schedule was today because he needs one one and talk to me because he said it was clear "things were not well." I appreciate their concern, I guess. But it's none of their business and just shows that I apparently cannot control myself or things if they are asking these questions. As far as c goes, it kind of is his business since I did choose to "share" with him and I've purposely been an ass. I know he is trying to be kind. But I don't want to talk to him. I will either have to continue being a jerk or say I'm sorry and that everything is fine. But I'm tired. If I dont have a plan, I am going to fall apart and I wouldn't even know how to explain to him what isI going on right now. He is really a great guy and is very caring, but I just don't want to have this talk that he apparently thinks we need to have. I felt bad for being a jerk, but now I'm wishing I had been more of a jerk. Now I'm all stressed about it. I I tell him what's really going on, he's going to think I've seriously gone nuts.
I'm glad she gave me a heads-up.
Expert:  TherapistMarryAnn replied 5 years ago.


It is just fine that you want to be away from people now. But you may not have to use anger to do it, though that is a natural response after what you have been through. You could just tell people that you are going through a difficult time right now and need space. It may require some extra boundary setting when some of them ask why or if they can help, but it may also leave your supports intact so when you need them they are there. And you won't feel the need to go around apologizing when you do feel better and are ready to reconnect.

There are alternatives to how you can respond to your minister friend. You don't have to use more anger or give in and pretend you are ok. It is just fine if you make a call to his office (when you feel he may not be there if you want) and tell him that you are sorry about how you treated him, you got the message he wanted to see you and you are just not up for it right now. Tell him that you have hit a rough patch and feel the need to concentrate on getting better. Let him know that you will contact him when you feel ready and if you want, ask him to pray for you. Praying for you gives him an action to take so he does not feel helpless and decide to contact you to offer help. Then let it go at that. If he tries again to contact you, you may have to be a little more forceful. But you can get the message across firmly and without anger.

It is hard on you to have others trying to get into your space. It is just enough of an intrusion that you may feel violated and reminded of the attack. Anger is a response that gets others out of your space quickly and helps keep them out. But it is not a productive response towards those who support you and care about you. Explaining that you need space will do the same thing.


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Customer: replied 5 years ago.

Hey Kate. Thanks for the advice. He ended up calling and not stopping by. He just said he wondered if I was okay and thought I might be struggling, judging by my texts. I told himn I was, and kind of explained that I as just dealing with some pretty intense feelings right now, and kind of taking it out on him. He said I was welcome to take it out on him if it helped, and that he would be praying for me and that he was available if I wanted to talk. So it went well, and he wasn't pushy or mad, and seems to understand.

I had an appointment with my therapist today, and it actually went pretty well. She had spoken to her director and a few other colleagues, and just kind of gave me their thoughts, which were basically their reactions to a summary of the story, and their thoughts that things are headed in the right direction, and that what I am experiencing now is a good thing, in their eyes. They basically just reiterated what she has told me about where my thoughts need to end up, and that this is a good path towards that. It did make me feel better that although they thought it was unique that I put it away so quickly and so well for so long, they all seemed to think this is all normal and what needs to happen.

Then she told me that since my appointments were seemingly the only place I could let down my guard, that she just wanted me to be and to cry and to say whatever I wanted. We discussed that I am a lot more angry than usual, but she thinks it's a good thing. What is ironic is that she basically wanted me to come in and cry or whatever, and I didn't cry at all this time, which was fine. But I knew I could. I was kind of close, but then my psychiatrist happened to return my call in the middle of our session, and my therapist wanted me to answer it. It was really good timing. I put her on speaker phone, and my therapist was able to explain what was going on much better than I could. She told the Dr. about the kind of "breakthrough" I had after I spoke to her, and what she thinks is going on, thoughts I've had, feelings I've had, etc. It gave her a good understanding. They both seemed really pleased and agree that it's a lot of progress, even though I feel like crap right now. My psychiatrist said she knows it sucks, but I need to believe them that this is a really good thing and has to happen, and there is really no other way.

So -- she doesn't want to give me any more meds to help feel better during the daytime. She wants me to "experience" this and not try to numb myself. She promised it would be worth it. She was surprised I am working right now. Really? Did she think I could just decide not to go to work? She didn't think it was a great idea, but I think understands I don't have a choice. I mean, can other people just decide to take off a week or two because they feel bad? Anyway, she was really concerned about the sleep and prescribed me something that she says will almost certainly work, and as a bonus also works to prevent migraines. I am looking forward to trying it tonight.

Meanwhile, I am going to whittle things down only to what I have to do. I'm going to sit out of choir and praise team for the time being, as well as canceling my drum and banjo lessons for the month, so I will have some extra time to sort through things. I guess if you, my therapist and my psychiatrist all think this is a good thing, even though it feels so bad, then I'll just go with it and stop fighting it (although that wasn't really working anyway). It'll be better if I can sleep. I just hope it doesn't last too long.

So I am trying to adjust my attitude and grin and bear it. :)

Customer: replied 5 years ago.
oh, also, my therpist's colleagues also suggested a support group somewhere down th eroad, like you did.
Expert:  TherapistMarryAnn replied 5 years ago.


It's good that everyone who is helping you is on the same page with what you are going through. You certainly have been blessed with a good therapist and psychiatrist. They seem to care about you very much and since they are working so well together, you are getting some very good care.

I'm glad it worked out with your minister friend too. He sounds like he is a loyal friend.

I don't know anyone that could take off a week at a moments notice to cope with a situation like yours, so your surprise at that comment is appropriate. But I am sure she was just trying to be supportive and helpful. Cutting back on your activities though is a very good idea. That will at least make your life a bit more manageable.

I know this is not easy to go through what you are dealing with. Sometimes all you want is to have peace again. Every day can feel like a challenge when you have so many strong emotions and they feel hard to control. But this is a good thing. Before you were burying your feelings and trying to go around them in order to not have to cope with them. But that could not work forever because it is in your nature to be emotionally healthy. And being an emotionally healthy person, your mind would not let you keep the trauma buried. So it came through during your conversation with your psychiatrist. It is a flood of emotions, but it could not be anything else because the trauma was so intense. Your emotions are matching the level of the trauma, which again is a very good sign. If you stayed calm or even found the situation amusing, there would be a lot more reason for concern. But your tears, anger and other feelings are all normal responses to an abnormal event.

I think a support group would be a good idea. Maybe one online to start. It would help you feel safer and let you get used to talking about how you feel with others before you go face to face in a group.


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