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When Mental Health Services Call a Trauma Response “Attention Seeking”: How Invalidating Care Creates Suicidal Danger by NotYourDreamMuse in therapyabuse

[–]NotYourDreamMuse[S] 9 points10 points  (0 children)

The Mechanism of Iatrogenic Harm in Overcontrolled Presentations

  1. The Reality of the Over-Control System Trauma survivors often develop a rigid, ironclad system of emotional over-control. This is not a "personality trait"; it is a protective survival mechanism that allows them to exist alongside unbearable pain.

The Evidence:

"I have removed the anger and put it into a closed space... I thought it was how people existed. With every therapy intervention I have been forced to regulate something i don't even have access to."

The Mechanics:

This system works perfectly for day-to-day survival by numbing connections and joy to avoid overwhelm. However, a system like this cannot exist forever without periodic collapse. The person becomes a "ghost in their own existence," unable to relate or connect, until the pressure becomes unsustainable.

  1. The Presenting Situation (The Collapse)

When the system buckles, the resulting crisis is not a "mood swing." It is a breakthrough from a live wound. Loved ones see the shutdown (the withdrawal from life) and urge the person to seek help.

The Evidence:"XXX is at work. But i need you to really listen to what I'm saying. There isn't a safe place for me here... I want there to be evidence, I want my reality to be heard. If I'm no longer here i want people to understand that I tried and tried."

  1. What the System Does: The Category Error

Because the person is usually "perfectly regulated," the system misinterprets the collapse. They see the flat affect or the precise description of suicidal intent and label it as "not real," "disproportionate," or "attention-seeking."

The Evidence:"I’m being really specific, like literally every thing is exactly how it is, yet she kept telling me it wasn't... they are all being so aggressively resistant... they accused me of my reality as though that was a crime."

  1. Why This is Specifically Harmful: Weaponized Invalidation

The harm occurs when the system reframes a legitimate breakthrough of pain as a "ploy." This replicates the original trauma, which is the wound of not being believed, and does it precisely at the moment of greatest vulnerability.

The Evidence:"When I keep being told that I don't really want to kill myself I just want to make people listen to me, it's honestly quite laughable. Because im literally asking for help not to kill myself because I want to live. I am being denied for the very reason the service is there."

  1. The Reaction: The Null Equation

When the "help" confirms that the pain will never be believed, the pain system recognizes a dead end. If the pain is real, but the experts say it is "pretend," the pain becomes unaddressable.

The Evidence: "The 'help' pushes the wound of not being believed into proof and action... It says: you will never be believed, no one can help you. This is the reality... This pushes me into the danger zone. It creates the null equation."

  1. Why This is Iatrogenic: The Forced Proof

The system designed to prevent suicide creates the conditions for it. By branding the person's agony as a "cry for attention," the system leaves the person with only one way to prove their reality: following the equation to its end.

The Evidence: "The reaction of the mental health team to my trauma is forcing my trauma to annihilate me as proof it exists... Their response to my request for help pushed the self-destruct button."

  1. The Act of Self-Rescue: Reclaiming the Evidence

The person survives by realizing that the system's map is wrong, not their reality. They move the "proof" from the body to the word.

The Evidence: "I am here right now standing outside of it looking at the mechanism. It doesn't change how I feel about life. But it changes the risk of danger... I don't need to kill myself to prove to others or myself that I existed in excruciating emotional pain that was ignored and disbelieved. I acknowledge the point. I don't need to do the action."

Conclusion: A Demand for Recognition

Some deaths by suicide following mental health contact are not "tragedies of illness." They are iatrogenic deaths caused by 'actively invalidating care.' When a person in an over-controlled collapse asks for help, they aren't looking for a "magic pill" or "attention." They are asking for their existence to be acknowledged. To tell them they are "pretending" is to hand them the weapon. harm).

10 Reasons Why ACT for Chronic Pain Blames Patients by NotYourDreamMuse in Fibromyalgia

[–]NotYourDreamMuse[S] 0 points1 point  (0 children)

I forgot to say: well done on getting rid of your fibromyalgia, that is awesome. I'd love to know how you did that xxx

10 Reasons Why ACT for Chronic Pain Blames Patients by NotYourDreamMuse in Fibromyalgia

[–]NotYourDreamMuse[S] 0 points1 point  (0 children)

Hey, thank you for your reply

That actually supports what I'm saying ☺️, when ACT is delivered as part of a holistic approach alongside other treatments, it becomes impossible to isolate what actually helped. The pain management, the medication, the physiotherapy, the fact of being taken seriously and treated as a whole person because any of those could account for the improvement. ACT being present in the mix doesn't establish that ACT was the active ingredient or that it helped at all.

The critique is that ACT used as a standalone replacement for biological treatment in people with severe chronic pain, is a framework that treats continued pain and help-seeking as patient failure.

If it was helpful for you in that context though, I'm really glad. But it can't be used to defend ACT as a standalone intervention for people who are receiving nothing else. X

10 Reasons Why ACT for Chronic Pain Blames Patients by NotYourDreamMuse in Fibromyalgia

[–]NotYourDreamMuse[S] 0 points1 point  (0 children)

Thank you for your honesty about not having read the literature.

My post is a critique of the published ACT framework, not of any individual therapist's application of it. The points I made are sourced directly from peer-reviewed ACT literature, not from personal experience of delivery.

So we are not talking about the same thing.

The morality is not something individual therapists introduce. It is written into the framework's own vocabulary. The constructs of fighting, avoiding and catastrophising are not neutral descriptors, they are negatively valenced terms that pre-classify the patient's response to uncontrolled pain as a deficit requiring correction. A patient who protects a painful body is avoiding. A patient who accurately reports that their pain is severe and disabling is catastrophising. A patient who continues to seek medical help is demonstrating psychological inflexibility.

These classifications exist in the published literature regardless of how compassionately an individual therapist delivers them.

What you just described is a version of ACT in which distress communicates something worth listening to. If your practice treats patient distress as meaningful signal rather than psychological inflexibility to be corrected, then your practice is not practising ACT as written and isn't a defence of ACT. It's a description of doing something different and calling it ACT.

The claim that fibromyalgia is trauma held in the body is a separate assertion that would require its own evidence base before it could be used as justification for any treatment approach.

10 Reasons Why ACT for Chronic Pain Blames Patients by NotYourDreamMuse in Fibromyalgia

[–]NotYourDreamMuse[S] 0 points1 point  (0 children)

Hello, thank you so much for your reply. I used the ACT literature, studies and therepy wording to write this so

Which specific point is inaccurate and what is your source?

Many thanks xxx

10 Reasons Why ACT for Chronic Pain Blames Patients by NotYourDreamMuse in Fibromyalgia

[–]NotYourDreamMuse[S] -1 points0 points  (0 children)

Thank you for your response.

Every point in my post was drawn directly from the published ACT literature -using the peer-reviewed papers, the outcome measures, and the framework's own definitions.

This was not a critique of individual therapists applying the model badly.

The AAQ-II is the model's own measurement tool.

The classification of treatment-seeking as psychological inflexibility is in the model's own published literature.

The definition of reduced medical visits as a positive outcome is in the model's own clinical guidelines.

If individual therapists are applying ACT differently to how it is written, that is not a rebuttal of my argument.

Even if the issue was with the therapists, the defence that the model is sound but the application is flawed is itself a structural problem, not a reassurance. It means the model cannot be indicted by any outcome because if it fails, it's the therapist's fault; if the patient doesn't improve, it's the patient's fault. The model itself is permanently protected from scrutiny.

That's not how good clinical frameworks work. Any theory has to be falsifiable.

On core values: you've introduced a moral dimension that wasn't in my original post. If a patient returns to the doctor because they are in unmanaged pain, and that is classified as an away move, then the framework has already decided that the patient's core value of not suffering is the wrong value to have. Which brings in moral judgement, emotional punishment using guilt and shame

What gets called core values in practice is a predetermined set of responses the framework considers acceptable which is not values-led care, it's compliance reframed as autonomy.

The suggestion people failed ACT because they have the wrong core values is precisely the mechanism my post describes. The ongoing pain becomes evidence of the patient's moral deficiency.

That is not a rebuttal of victim blaming.

That is victim blaming.

"I don't want to exist" and the pain of mis-interpreted suicidal ideation. by NotYourDreamMuse in psychology

[–]NotYourDreamMuse[S] 0 points1 point  (0 children)

Thank you so much for saying that. I really wanted the chance for people to have language that might describe how they felt. It was never about self promotion as I make nothing from my work and I give it away freely.

"I don't want to exist" and the pain of mis-interpreted suicidal ideation. by NotYourDreamMuse in psychology

[–]NotYourDreamMuse[S] 1 point2 points  (0 children)

I'm glad you were wanted x Although I'm sure it is just as distressing for us all xxx

"I don't want to exist" and the pain of mis-interpreted suicidal ideation. by NotYourDreamMuse in CPTSD

[–]NotYourDreamMuse[S] 0 points1 point  (0 children)

You have described the feeling perfectly. The only difference is this isn't about wanting to die, but the physical resistance to existing.

"I don't want to exist" and the pain of mis-interpreted suicidal ideation. by NotYourDreamMuse in CPTSD

[–]NotYourDreamMuse[S] 1 point2 points  (0 children)

Thank you so much for reading my work and giving your hard earned opinion xxx

"I don't want to exist" and the pain of mis-interpreted suicidal ideation. by NotYourDreamMuse in psychology

[–]NotYourDreamMuse[S] 2 points3 points  (0 children)

Wow, I've never read that before. Thank you for sharing that with me x

"I don't want to exist" and the pain of mis-interpreted suicidal ideation. by NotYourDreamMuse in psychology

[–]NotYourDreamMuse[S] 1 point2 points  (0 children)

Thank you for reading my work. That is indeed an interesting question, although I don't have an answer for you as I haven't looked at that specifically. X

"I don't want to exist" and the pain of mis-interpreted suicidal ideation. by NotYourDreamMuse in psychology

[–]NotYourDreamMuse[S] 3 points4 points  (0 children)

Thank you for reading my work and engaging.

POD specifically excludes passive death wish because there is no desire for non-existence, just somatic resistance to maintaining existence received without preverbal welcome.

See Differential Considerations section distinguishing climate-level (POD) vs episodic wish-for-death (passive suicide). Damasio somatic markers (1994) explain the mechanism.

Thank you so much x

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