CPTSD and Why You Might Stay in Therapy for Far Too Long
I think healthy therapy aims to work towards independence for the client. I do not doubt that theoretically, most practitioners would agree with this, though the reality is often very different.
Efficient therapy doesn’t just depend on having the right knowledge and understanding, but also requires emotional maturity on the part of the practitioner and a willingness on the part of the clients to open up and persist through the tough parts of healing.
While a premature ending of the therapy process is certainly not helpful, too long a therapy process in which progress has come to a halt is equally a waste of time and resources.
Dissociation and Containment in Treating Complex PTSD and CPTSD
The process of dissociation is part and parcel of any trauma. It is the cornerstone of Post-Traumatic Stress, and happens as a survival response because you feel emotionally overwhelmed. What this entails– concerning healing– is that you have to work through the dissociation in order to access the underlying emotions and bring completion to those same emotions.
You can only have completion of emotion when you have sufficient containment, and it is only within adequate containment that emotion can be held, and henceforth be processed.
If this is not clear, let’s look at it from the other way around.
Release and Resolution when Dealing with CPTSD
What can make the therapy process go on for too long is when there isn’t a clear understanding of the importance of containment and resilience on both the part of the therapist and the client.
When you experience an emotional release without having the strength to meet the intensity of the emotion fully, it can lead to a cycle of “build up and release” that can continue over and over again. It might feel like you are doing the work, but what happens is that you might become addicted to the release part and actively seek it; without containment, this faulty process will repeat itself indefinitely.
Release is not necessarily resolution!
What might also happen is that when you start to feel the suppressed emotion and the history that goes with it, is that the emotion is plainly too overwhelming to hold and therefore retraumatizes you.
It is of vital importance to go in and out of overwhelming emotions to build up resilience and containment. If you do not do this and do not create sufficient brakes within this process, you will drown in the overwhelming emotions all over again to the point of freeze and dissociation, which obviously is not helpful.
The Limitations of a Cognitive Approach Only in Working Through CPTSD
Most standard therapy has a top-down approach, meaning that it uses a cognitive understanding only. While this might be helpful when you have just started CPTSD treatment, as it is easier to talk about what happened to you rather than talking into what happened to you, this approach doesn’t go deep enough to allow you to work towards full resolution.
This top-down process does help, though, to create a road-map and understanding of what has happened to you, and might help to ease some of the blame, shame, guilt, and self-reproach.
What it most often does NOT do is process the emotional content itself, which makes up the trauma. You can’t do this by talking over what you feel and what happened to you. You will have to go into the emotional residue and somatic holding of it in order to come out of it.
Therefore, there is a limit to a cognitive approach only, and when you stay too long in this type of therapy, you will likely feel you are just rehashing what happened to you without making any further strides in healing your Post-Traumatic Stress and Complex PTSD.
The Web of Codependency: Transference and Projection in CPTSD Treatment
The last issue I want to mention here is the trickiest one, and that is the codependency that can creep into the client-therapist relationship
When you go to counseling or therapy as a patient, you have realized that you need help. That mindset and the reaching out for help comes with a certain vulnerability. It comes with a certain need, which makes you decide to enter into a therapeutic relationship.
From a therapeutic client-therapist relationship perspective, being vulnerable with or even having some dependency on your therapist for as long as the therapy lasts, can be acceptable and be naturally present.
This dependency might get compounded, though, if the client has severe neglect or abandonment issues. As a therapist, you have to be extra vigilant in managing the resulting attachment by having healthy, professional client-therapist boundaries.
When Things Get Ugly: A Lack of Boundaries and A Need for Validation from Both the Client and Therapist
In the above scenario, what might cause therapy to go on for too long is what I refer to as the “savior syndrome” of the therapist, which likely comes out of a need to be validated.
A therapist might get too involved in the healing process of the client and overextend him or herself. That being too involved and overextension is often there out of a need to get validation and projects itself as trying to get positive results and getting positive feedback from the client.
What happens then is a subtle play of projection and transference between client and patient that draws out the therapy process.
Within that projection and transference, a lot of confusion comes into play. If you aren’t moving along as desired or expected by your therapist, the therapist becomes either disappointed or might get angry and upset with you.
In turn, you, as a client, will pick up on that, and– if your default is pleasing and codependency– you will try to please and maybe even want to convince yourself that you are getting better in order to curry favor with your therapist, often followed by the reality that you aren’t making much progress.
This confusing back and forth of playing on each other’s needs can become a cycle which both of you can get stuck in; it isn’t very pleasant, to say the least, and often ends with bitter feelings on both sides.
Have you had times where you felt you stayed into therapy too long? Based on the points mentioned in this article, what were the reasons? Share your thoughts below.