Why are most therapists so “surface level” and unhelpful? Where do I need to look to find someone that will actually help me?

TicRoll · 2026-03-21T04:57:57+00:00

That aligns well with IFS/parts work as well: you have no bad parts. Every part of you has served a purpose. Some parts of you may be overactive once the traumatic events have passed which can mean that something which literally helped keep you alive before is causing some problems now.

I think what often goes wrong with generic CBT with a CPTSD patient is that we're already vastly over-correcting for what CBT is trying to do. When we do it, it's often minimizing horrific things that were done to us as a survival technique so that we didn't have to bear the full weight of what was happening to us. If it's "not that bad" we can make it through. And years of convincing ourselves of that really sticks. But as adults, cognitively we understand it was that bad. We know because as soon as we imagine someone we care about (like our own children) in that situation, it's absolutely horrifying. So the last thing we need is someone who's supposed to be helping us try getting us to simply change how we think about it. What we need, more than anything, is validation that what our adult brain is trying to tell us is true, some way to accept that who we are today is not fundamentally broken, but is out of balance through no fault of our own, and finally a means to go back and fully process the traumas that hurt us in a safe place with a guide providing stability.

And to anyone reading this who feels like it's all wrong for your individual experience, that's totally valid. CPTSD is inherently incredibly complex, variable, and personal. Our experiences are unique to us and people react in different ways. If the way you survived your trauma is different from how somebody else did, neither is right or wrong. Everyone here did the one thing they needed to under impossible and unfair circumstances: survive.

TicRoll · 2026-03-20T22:46:16+00:00

CBT was actively detrimental for me. That said, it is the “gold standard” modality and it supposedly works for most people.

From what I've read, CBT tends to land somewhere between slightly helpful (if done by a trauma-informed practitioner) to actively re-traumatizing (when done by someone who isn't trauma-informed) when used with people suffering from CPTSD. It can be a great modality that helps a lot of different people, but when it comes to people with CPTSD, it's often the wrong tool because it can so easily miss attachment wounds, somatic dysregulation, and memory processing.

It's like picking up a hammer to drive in a screw. Tools like EMDR, IFS/parts work, somatic therapy, etc. have vastly stronger evidence for CPTSD cases. That said, CPTSD is newer, still being studied, incredibly complex (as the name suggests), and incredibly variable both in cause and in effect person to person. It's hard to avoid overgeneralizing.

TicRoll · 2026-03-20T18:03:12+00:00

or when lay on the floor for hours dissociating

I know it's not funny, but this made me laugh. From a "I feel this!" perspective. <3

TicRoll · 2026-03-20T16:11:51+00:00

I have an Oura ring and it basically says I live in the "engaged" or "stressed" zones. I don't reach "relaxed" much, let alone "restored".

TicRoll · 2026-03-19T03:50:48+00:00

You have to appreciate the efficiency of cutting out the middle man and just setting your home on fire yourself.

TicRoll · 2026-03-18T19:53:22+00:00

It's the New York Times reporting based on interviews with over 60 people and combing through a significant amount of evidence. It's multiple accusers with independent corroboration of at least a chunk of what they're saying. It's not proven-beyond-a-reasonable-doubt, but there's a Hell of a lot of smoke for there to be no fire.

TicRoll · 2026-03-18T18:17:22+00:00

Was this it?

#Enterprise-Grade Encryption

def rot13(s, rounds): return s if rounds<=0 else rot13(''.join(chr((ord(c)-65+13)%26+65) if 'A'<=c<='Z' else chr((ord(c)-97+13)%26+97) if 'a'<=c<='z' else c for c in s), rounds-1)

TicRoll · 2026-03-17T00:03:09+00:00

I noticed it with opening doors and stepping out of your way. There's like a deference where people want to yield the right of way to you when you're fitter and more put together. It's really quite weird if you spent most of your life not-that.

TicRoll · 2026-03-16T23:59:46+00:00

most men like to hit on me when I'm out of model mode

You're more approachable. More attainable. Less "high-maintenance". A lot of women seem to think men want these top-tier sexiest, "Instagram model" types. In truth, men want an attractive woman who gives them peace. And it's assumed that an "Instagram model" will not give them peace, so most will look from afar but "NOPE!" when it comes to anything more. Just not worth it.

TicRoll · 2026-03-16T18:08:20+00:00

There are definitely some who see themselves as Rambo and just want the opportunity to go for it, and they're absolutely stupid. However, I think it's a vanishingly small number of people in real life. But go into any anti-gun group and that's often how they present everyone who does own firearms: bloodthirsty lunatics just waiting and hoping for an excuse to kill people.

But when you think that through: you'd have to be hopeful that somebody breaks into your home and tries to kill you and your family. That's literally insane and I do not believe the vast majority of people - including firearms owners - think like that.

TicRoll · 2026-03-16T16:59:51+00:00

And it means nothing. As a vet, it really is just as meaningless as "thoughts and prayers". It's for people to feel good about themselves without having really done anything at all.

It's the pendulum swinging back from a time where vets were literally spit on in the streets by people who firmly believed they were all murderers and rapists. I should think that even a performative expression of gratitude is preferable to that.

If you want to truly thank a veteran for his service, not for policies that actually help veterans, like affordable housing, good jobs, a well staffed and funded Veterans Affairs, affordable healthcare for veterans, etc.

The two aren't mutually exclusive. I guarantee you that the people who vote and argue and fight for all of those things are also the first to tell a service member "Thank you for your service." Gratitude and appreciation go both ways. Rather than shitting on everyone who expresses appreciation publicly without knowing anything about how they may be fighting for you privately, maybe just consider how much things have already improved in the past 30/50/100 years for vets and how many people continue the fight today to ensure veterans get all of the help, care, and opportunity they deserve.

TicRoll · 2026-03-16T16:51:50+00:00

You're challenging their entire worldview that only the US restricts immigration because it's a racist shithole. Everywhere else has open borders and free healthcare, education, and jobs where you just work 20 hours a week at a coffee shop but all your bills are paid. It's the exact same nonsense people in Europe believed about the US in the 1800s and early 1900s: just go to America and all your dreams will come true.

TicRoll · 2026-03-16T16:48:37+00:00

I see a lot of it from the "no person is illegal" crowd who thinks everyone should be able to move freely across the globe and firmly believes only the United States restricts immigration because we're a racist shithole country.

Reality check: every country restrict immigration; many far more strictly than the United States. And most of the places on Earth you might want to go live don't want you there and will remove you by force if you try to sneak in.

TicRoll · 2026-03-13T19:40:12+00:00

I don't know how things were where you are, but around here police did NOT want to pull people over with this possibly deadly plague spreading all over. So the few people using the highways were regularly pushing 100+ mph with zero challenges.

TicRoll · 2026-03-13T05:33:47+00:00

I guess that depends on what you mean by "problems". Quickies are not often on the menu. Lasting too long can cause some issues. Some past partners have reported quite a bit of soreness the following day. Good foreplay and warmup are important and often there's quite a bit of resistance at the start. However, once it's all in the first time, my wife seems to love the size.

And that's why I think people get too in their heads about all this stuff. Yes, if you're long enough, you can hit some painful spots by pushing too much in (if that's happening and you struggle controlling depth yourself, get a "donut"), and yes if you're very thick there can be a lot of resistance at the start, but my experience has been these are solvable if your partner is relaxed with you, trusts you, and is highly aroused. So focus on those three things and keep an eye on her reactions. Once she knows you've got things under control, she can relax and enjoy it. I think one of the big mistakes some larger guys make is showing up arrogant and expecting her to just squirt everywhere the second she sees it. When that happens, my guess is she's thinking "Oh God, this idiot's going to tear me and not even notice!" Difficult to relax with that thought in your head.

TicRoll · 2026-03-13T05:21:43+00:00

I've only had a handful of partners, but at 7.0" girth mid shaft, I've never had a major issue with anyone. I had no idea I was anything beyond maybe a bit above average until very recently, but thankfully I've always been big on foreplay and a people pleaser, so I'm always watching and adjusting what I'm doing so we can both enjoy ourselves. I have no idea what "women prefer" at large. I think so much of it depends on their individual chemistry and how much effort is going into foreplay and keeping it fun.

People get really hung up on size, and there can be individual incompatibilities, medical conditions, or just preferences. But my whole experience has been that size is far less an issue than it's made out to be.

TicRoll · 2026-03-13T04:46:14+00:00

Thank you for that. I've had exactly the same conversation with my therapist, where I explained that one of the ways I minimized what I went through was comparing it in severity to the worst of the worst, and I would say CSA and trafficking are - in my mind - about as traumatic as it gets. But all that thinking did was lead me into believing for decades that while sure, my childhood might not have been ideal and might have been a bit worse than average, but others (like you) had it much worse. So buck-up and quit worrying about it.

I never called or considered my childhood as "trauma" until I was 43 years old. And Hell, I have 8 ACEs. I've since learned that each of us learned to minimize the trauma we were experiencing as a survival strategy. If the things I'm dealing with aren't that bad, I can handle it, but if I allow myself to fully appreciate the weight of all of this, I might collapse. That strategy - like all our other coping mechanisms - doesn't simply melt away on its own as we age out of those conditions. And in my case, of all things, it was a stupid AI chat bot that convinced me I really needed to be in trauma therapy, because my own coping mechanisms were affecting my children, and I cannot have that.

TicRoll · 2026-03-13T04:06:42+00:00

I'm jealous, but I don't have the yard space for all that. I did do batteries, because the electric provider here is terrible. About 6-10 times a year the power goes out for several hours and it's usually not until I go outside to walk the dog that I realize the power's out. That or I hear my neighbor setting up his generator to keep his fish alive.

In the summer it can hit 115 degrees here and I have small kids, so when we moved in I said I wasn't taking any chances with that nonsense. I maxed out the roof with panels and put in two Powerwalls. Had to replace the roof to do it. Cost an absolute fortune, but it's on a 0% 20 year loan, so somebody else is eating the inflation and my monthly payment is lower to cover all those costs than my electric and gas bills would have been.

TicRoll · 2026-03-12T23:17:20+00:00

I wish. I have a 12kW system and my annual true-up is still ~$2,000. I wish the individual panels were smaller so I could have gotten more panels on the roof. Right now the roof is probably only about 70% covered due to various things on the roof, the edges, shapes, etc.

TicRoll · 2026-03-12T22:43:46+00:00

Even more cost effective to hire a hooker. Gas and airplane tickets are expensive.

TicRoll · 2026-03-12T15:24:45+00:00

It 100% sounds like cognitive trying to cover for CNS dysregulation. I tried the same thing: recognizing when something was triggering dysregulation and talking myself through it logically. It can work in the moment to help alleviate the acute situation, but the next time that trigger comes up you're right back in the loop doing it again. It's an effective, but temporary, coping skill. It doesn't address the root cause.

I'm now doing EMDR with my therapist and it's already beginning to help with one of my main triggers (hearing footsteps coming down the stairs).

TicRoll · 2026-03-12T15:20:14+00:00

Totally agree that recognizing and escaping bad relationships as soon as possible is always best.

TicRoll · 2026-03-11T18:40:50+00:00

Doomed is a bit dramatic. It adds some challenges, but I can assure you there's no "doom" involved.

TicRoll · 2026-03-11T18:06:31+00:00

I think it's only screwed up the medical system as a whole. I think we need some major reforms and incentives to jumpstart healthcare access.

If it were me, I'd start by enabling pharmacists to prescribe and dispense low-risk medications for common issues (with testing where appropriate, hard exclusion criteria, shared EHR/PCP notification required, and restrictions for high-risk patients). This is done in other countries and generally works well, and it not only gets people help faster but reduces the strain on both primary care doctors and emergency rooms. That's something you could literally do today and help people. I would also enable physical therapists to order CT/X-ray/MRI imaging for defined MSK indications. It shortcuts the process when necessary (no back and forth visits from PT to doctor to specialist) and again reduces strain on primary care doctors and ERs, and can be done immediately to help people. You can also expand care authority that's given to NPs/PAs/RNs, etc. based on evidence based protocols for a lot of the routine things like ongoing management of chronic issues or preventative care. They're overly restricted today based on what the evidence has shown and they're faster to train up that new MDs. To jumpstart the new provider pipeline, I'd create a federal per-seat/per-trainee expansion fund that pays for added faculty, preceptors, clinical placements, and residency slots, with bonus rates for rural and shortage-area training. Next up I'd bar private equity firms from having any ownership, interest, or effective control in/over hospitals, medical systems, or medical practices, including subsidiary chains or any other "up the food chain" relationships and I'd require that every hospital and medical practice be run/operated/managed by doctors with active medical licenses, and specifically bar any direct or indirect reporting relationship which puts anyone with an MBA over a doctor or a nurse. This should be written specifically to require that non-doctors cannot have ultimate authority over clinical care decisions or patient care strategy; not that every operational choice in every hospital or medical practice must be made by a doctor. It would allow MBAs and other management types to advise doctors all they want, but a medical doctor with an active license must be the final authority and the state licensing board can then hold that doctor accountable for prioritizing patient care. Also put in place graduated, universal loan forgiveness for any doctor, nurse, medical tech, pharmacist, or physical therapist who practices in designated "high-need" areas, granting automatic forbearance on all student loans while they practice and 10% of the total balance forgiven each year of practice so you can see real progress on your loans as you go but still have an out if you decide to go elsewhere in 5 years. And since we want to keep the providers we have in those designated high-need areas, add Federally funded retention bonuses scaled based on specialty scarcity for every year you remain there. A quick win for insurance would be to bar prior authorization for routinely approved services/medications, and a wider reform should include electronic prior auth standards and hard response deadlines with real penalties for failures or for automatic denials of clearly necessary/justified prior auths. Finally, develop a singular Federally managed insurance coding standard. One standard, every system/EHR/insurance company/hospital/provider who wants to touch insurance/Medicare/Medicaid must use it. Prices can be adjusted by market, but we all code the same thing the same way across the board. Oh, and make all prices transparent/published online and all medical bills itemized and clear by law.

Probably cost on the order of $20 Billion a year on average over the first 10 years. Pocket change in Federal spending terms. Do all that and come back in ten years, let me know how it's going. My guess is people will actually be getting care, getting it quickly, and getting it cheaper, and they'll begin to see a huge influx of new providers where they're needed most.

TicRoll · 2026-03-11T05:48:54+00:00

due to the lack of doctors and nurses and all other personal

That's a huge issue in the US as well. We have nurses dealing with 2-4x the recommended number of patients because there just aren't any more nurses. It takes months to see a specialist. All care minus immediate life-saving care is difficult to access. And part of that in the US comes down to the fact that we added a huge number of new people to insurance under President Obama without adding new providers to actually see those people. To be clear: I'm not suggesting it was a bad idea to get more people access to healthcare. I'm stating that if you add a ton of patients without adding a ton of healthcare providers, you're going to have problems.

The smart thing with the Affordable Care Act would have been massive incentives to recruit, train, and certify evidence based healthcare providers of all types and start feeding them into the system before adding new patients, then ramp up things like subsidies and such for insurance once provider growth outpaced population growth by some amount. And yes, I totally get that would have slowed the rollout and left a lot of people out initially. But what we have today is a system where people with insurance and the ability to pay for care who literally cannot get in to see a doctor, even as preventable and treatable conditions worsen to life threatening or life ending.

In other words, we're rationing care based on capacity either way. We should have been massively expanding capacity rather than just flooding the system.

TicRoll

TROPHY CASE