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Ask TherapistMarryAnn Your Own Question
TherapistMarryAnn, Therapist
Category: Mental Health
Satisfied Customers: 5822
Experience:  Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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Kate. I'm fine. Was just having a tough evening. I was so

Customer Question

Hey Kate. I'm fine. Was just having a tough evening. I was so looking forward to starting my break from choir & PT and havinga few hours 2 nights a week alone, but it seems that it may not be such a great idea.
Submitted: 5 years ago.
Category: Mental Health
Expert:  TherapistMarryAnn replied 5 years ago.

Shay, what happened that made you believe that your break may not be a good idea?

Customer: replied 5 years ago.

Maybe it's not a good idea to have that time to be alone and think. I normally wouldn't have been home that early at all, but I just came home a little after 5 after my appointment to get set up on the bipap machine. So maybe it will be better with less time or if I use that time to work. But shortly after P left, I had one of those flashback things again, and it wasn't pleasant, and I was alone (although I'm glad P wasn't there) and I can't even call Linda or talk to her about it tomorrow. I think that if I hadn't been at home alone, thinking, and instead was at PT being distracted, it wouldn't have happened.

Expert:  TherapistMarryAnn replied 5 years ago.

Maybe you would not have had the flashback if you were not home alone. But you also should consider that you have had two flashbacks already and both of them came when you were very busy and preoccupied. So it may not be triggered by how busy you are but by something else entirely.

Most flashbacks are triggered by a reminder of the trauma in some form or another. At this point, we have not been able to find out what your trigger is. But there is something, because that is the nature of flashbacks.

You could have called Linda to talk about your flashback. It might not felt the same as before because your relationship is going through a rough time, but she is still your therapist and there to help you. And any support would have helped you.

Staying busy is a way to avoid your feelings. It is a form of repression. If you feel ok emotionally, you will be alright alone or with others. But if there are things you do not want to think about or something you are trying to avoid, being alone is going to bring those things closer to the surface and make you feel uncomfortable.


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Customer: replied 5 years ago.


That's a good point - that my prior flashbacks came at a time when I was in the middle of working on something.

Is the trigger necessarily the same every time? Or can there be multiple triggers?

I guess saying I "can't" call Linda is inaccurate. I don't want to call her and didn't want to call her. I didn't feel comfortable doing that while these other issues are outstanding, and I don't think she has a clue I am even upset about the past few weeks, and I would have been tempted, if I did talk to her, to at least let her know everything was not okay there. I know she is still my therapist, but it wasn't good timing. I did think that support may have helped, which is why I wanted to check if you'd be online, but I really didn't think you would be, and so missed you. But it all turned okay. I ended up calming mysef down and dealing with it fine on my own.

Expert:  TherapistMarryAnn replied 5 years ago.

It is possible to have multiple triggers for a flashback. Everyone is different in how they react and what might trigger their flashback. And trigger can be through any of your senses- sight, sound etc. So if you see something one day that reminds you of the trauma, that could trigger the flashback. But the next day it could be a sound. It all depends on you, your experience and your memories and triggers of the event.

Possible triggers:

Taste- something you were eating or drinking before the attack

Sounds- words you heard during the attack, sounds like nature or other outside noises, things you may have heard but do not recall like the distant sound of a car door closing, someone crying or in pain (mimics what you may have felt or did), anger expressed through words or sounds.

Sight- objects associated with the attack like ones that were used or just in the area, anyplace that looks similar to the area of the trauma, someone who looks like the attackers, or seeing a story of someone who was attacked

Smell- any reminders of smells from right before, during or after the attack including your surroundings or the people that hurt you (a cologne or deodorant for example)

Touch- including someone coming close to you or even talking about being close to you. An accidental bump or touch.

This might give you a better idea of what triggers your flashbacks.

It is perfectly fine that you didn't contact Linda, especially if you feel it would have done more harm to you than good. I'm glad you tried to contact me and I'm sorry I missed you. I wanted to be there for you.


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Customer: replied 5 years ago.

I don't know what triggered it last night, then -- it could have been anything. Maybe it was a combinaton of the fact that Pat had left the windows open and it was kind of chilly (I HATE being cold, especially after that happened, and it was windy and fall-like last night) and the fact that my stomach was cramping (which it did for weeks after what happened)? Who knows.These things have happened before, of course, with no flashbacks, but I never had any at all before. I know it wasnt a smell. I am super-sensitive to smells, so I would remember if that was it. Nobody was around me to touch me or come close, so that wasn't it. Sound-wise, I don't know. The windows were open, so I could have heard anything. All I remember hearing were coyotes last evening and the yipping dog down the street (hopefully not yipping because it was being attacked by coyotes :) ). But I know it's not the coyotes (never heard them on Ohio) and that dog yips all the time. As far as anger - I am very sensistive to people being angry (especially men), but I was alone. Maybe something I was watching on tv? I don't know. I have been pretty angry lately, but I can't trigger myself, can I?

I did feel like you were there for me last night, even though we missed each other. That in itself made me feel not so alone :) So, thanks.

Customer: replied 5 years ago.

What can I do to move ahead with this other stuff, regardless of how long it takes to either work outthings with Linda, or figure out if we can, or find someone else? More and more I am thinking that if I choose to continue therapy with someone else, I may try a man. If there's a chance of transference, as you said, with me placing on him my feelings against those 2 guys, then does that man there would be no possibility of trust there? I certainly feel like it's more acceptable to be angry at my therapist than looking at her as a maternal figure. And if I did go see a male therapist (I would make sure it was an older one --- not near the age of those guys when that happened) - it's a given that he wouldn't touch me or sit really close or anything, right? I mean, I would imagine that that kind of thing is even more important in a male therapist/femal client situation, and especially where there has been a sexual trauma issue, right?

But on the other hand, I don't know if I could talk to a man about sex and sexual issues and couldn't ask the things I have asked Linda - and you, to some extent, out of curiosity. But it would be helpful, maybe, to get a guy's perspective? That's kind of what I was going for when I talked to C about it. ???

Expert:  TherapistMarryAnn replied 5 years ago.

You're welcome. I am usually getting ready for bed at that time of night but for some reason I was on. Maybe it was meant to be that we had some kind of contact so you could feel better, though it would have been more helpful to you if we could have talked.

You mentioned that you do not like the cold. Was it cold the night of the attack?

Also, your stomach cramping might have been a trigger, especially since it happened right after the trauma.

I don't think that your own anger would trigger it, although the emotions underneath could. Anger is a protective emotion. It covers vulnerability, sadness and fear. So you could have felt one of those emotions and was not aware of it.

It may be helpful to you to have a male therapist because it would present a different perspective to your situation. There may be transference and there also could be sexual attraction, which is another issue. And the touching/hugging would also be more highlighted with a male therapist. But it also could help you explore the feelings you have about men and the meaning it gave not only your attack, but your relationship with men since. But overall, it is not so important to consider the sex of your therapist as it is the experience. A good therapist who has experience and knows what they are doing is more important than if they are male or female. And if you feel uncomfortable expressing your sexual issues it is going to imped your progress as well.

If you end up searching for a new therapist and have only certain parameters, it's going to limit your choices. Saying you only want a male therapist who is older is not going to give you many options. And what if there are no good therapists that fit that criteria?

Your experience with Linda has been difficult. But not all therapists are like her, male or female. I am female and our experience (I hope!) has been different. We are not face to face, but we still are communicating. I also work with a number of therapists and they are all different. It is a matter of finding one that works for you, not that fits a certain criteria. If that happens to be a male therapist, then all those considerations will come into play. But you may find another female therapist that works out great too. It is who will help you the most that counts.


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Customer: replied 5 years ago.


Interesting. I hadn't really considered a sexual attraction issue with a male therapist -- more of a physical aversion, which is why I asked if it was a given with a male that there would be very strict physical boundaries. I would be worried that I would be scared, which would be a big problem.

I understand what you are saying about setting parameters and limiting my options, should I choose to seek another therapist. I also understand what you said makes a good therapist. etc. before. But there's really no way to tell whether there is even a chance for it to work until I meet with them once or twice, right?

You are right - our experience has been different, and you are a female.

Don't you think, that barring the past few weeks, Linda has been pretty good? I mean, I felt comfortable with her until recently, and I think she has helped me. What do you think? (please give me your opinion and not a neutral "it's what you think that is important" response :) )

Yeah - the stomach cramping happened during the incident and lasted quite a while.

As for it being cold -- yes it was. It was the week before Halloween in Ohio, so it was pretty cold - not below freezing or anything, but cold, and because what was going on did not allow me to, let's say, stay bundled up, I was flipping freezing the whole time.

So -- you didn't answer my question about what I can do to work towards resolving the main issues while things with Linda are delayed?


Expert:  TherapistMarryAnn replied 5 years ago.

You and I can work together while you sort out the situation with Linda if you find that helpful. You also could do self help through reading on line, books and support groups. It may not have the direct impact of therapy, but they are options.

A male therapist does not have any more boundaries in terms of touch than a female, at least as spelled out in the ethical codes. But if the therapist was a good one, then they would pay attention to boundaries based on your fear and other needs.

You could try to find a good therapist through asking your doctors for referrals or if there is anyone you know in therapy, asking their opinion. You can also contact the local universities to see if they can recommend someone (their counseling programs would be your best bet). You can also look up reviews on line and see if any therapist you are considering has a website. You may still have to meet with them once or twice to see if they would fit what you need, but that is the same for anyone you work with- mechanics, doctors, etc.

Linda has been helpful to you. You seem to have made a lot of progress with her. And if you feel you can continue to overlook the issues and work with her, that is ok. I can't tell how Linda is with you other than what you tell me. So as for knowing how she is from my point of view, it's too hard to say since I cannot see what she is doing. I am concerned, however, that you feel you are not getting the care you need. If you feel she has pulled back, given your regular appointment time away without explanation, and has missed your distress during EMDR, those are serious concerns. Therapy has to be a safe place or you will not progress. But if your gut feeling is that you want to continue until you are given a reason to quit, then I will support you. Unless Linda breaks a serious ethic code, your opinion matters more than mine does.

It sounds like the cold combined with the stomach cramps might have been enough to trigger your flashback. It might be helpful for you to write this down somewhere- date, time and what might have triggered this flashback. That way, you might be able to get a pattern going.