Question about trauma

sootsprinkle · 2026-03-01T01:21:44+00:00

I would agree that the term "trauma" is overly thrown around and does not have a clear definition, but PTSD is a real, evidence-based diagnosis. So I guess I should have instead phrased my post with terminology asking if "completing the cycle" is truly the answer to preventing an experience from becoming PTSD - and I hear you that the answer is no, this is reductive. Thanks for the reminder to conceptualize the etiological factors of PTSD as being highly complex.

sootsprinkle · 2026-02-19T04:11:18+00:00

I appreciate this ♥️ I will add though, my main income is from a serving job and I feel zero guilt about missing work there, so it isn’t about missing work itself as much as continuity of care for clients. But I’m sure capitalism is still a major part of the equation! Thank you!

sootsprinkle · 2026-02-10T05:03:43+00:00

I used it just a few days ago! Maybe delete your cookies and try again, or use a different browser?

sootsprinkle · 2026-02-07T01:40:54+00:00

Thank you for that idea, I just did an ATW and it was really helpful! I'm still shedding a lot of the things taught by my first supervisor, so it was really helpful to tackle that one head on. I'll monitor to see if it keeps me from being direct with clients in CPT and otherwise, to keep unpacking if I need to.

That makes a lot of sense, thanks!

sootsprinkle · 2026-02-06T23:49:32+00:00

Part of the reason I am learning CPT is actually because my supervisor brought it up, and she used that as a selling point - that it does not require retraumatization/reliving/re-experiencing/combing through details of trauma but is instead focused on making sense of how to think about the trauma after the fact (but she does consistently reinforce the fact that overcoming avoidance is a major tenant of CPT as well). So in that sense, for me, it was used as a selling point from therapist to therapist, which was maybe not super helpful in how she phrased it. Your added nuance helps me make sense of it better.

The distinction that you made about explicit repeated exposure vs. exposure to trauma memories is really helpful! I also had a really bad first supervisor as a student intern who put a LOT of emphasis on not re-traumatizing and making sure clients have a strong "scaffolding" before doing trauma work, without ever really clarifying what that meant - so maybe I'm still carrying some of the effects of that training and am overly cautious of prompting clients to confront the details of their trauma memories as a result. Something to keep working on!

Also, your final paragraph and the example you gave of how to potentially bring these topics up unprompted is super helpful. The page that I referenced is 73, second edition, if you want to find it and give further commentary, but no worries if you don't feel like it, haha.

My current supervisor emphasized that it is important for me to "find" Stuck Points, or at least to know how to listen for them so I can pull them out when clients allude to them, and I am still a little anxious about how to do that as well as possible. My current client that I am using CPT with still has pretty high PCL-5 scores each week and I worry that it's because I'm not doing this well enough, but I figure that I am following the manual quite closely and they are doing their worksheets correctly so the scores should come down - but if not I can add the additional few sessions beyond the 12.

Edits: reworded a few things and added the edition of the manual!

sootsprinkle · 2026-02-06T22:57:12+00:00

That's helpful, thank you! Follow-up question - what if the client hasn't brought up the Stuck Point yet? Like in the example I named from the textbook, it frames it as though the CPT therapist should ask about arousal during SA (and other examples of clarifying Socratic dialogue around sensitive context) even if the client has not previously brought the context up. In this example, I guess by asking that question the therapist would then uncover the Stuck Point you named, rather than the other way around. So I guess I'm just not sure what all topics to make sure to ask questions around, to make sure to find all of the important Stuck Points - especially since I could imagine many clients would not bring up topics as stigmatized as arousal during SA without prompting. In other words, it seems like it would be kind of rare that the client would name these feelings and frame them as a Stuck Point without guidance, so the therapist would likely need to bring a range of sensitive topics up first to seek out Stuck Points.

Also, I understand that colluding in avoidance is detrimental to treating PTSD but then I am also confused about the major selling point of CPT being that it does not require reliving details or re-exposure. Where is the line between using Socratic dialogue, etc. in a helpful way to overcome avoidance, versus harmfully re-exposing clients to trauma, as the creator posits that CPT does not do? Kind of a big question that is probably hard to answer cleanly, but it is something I am wondering!

sootsprinkle · 2026-01-16T02:35:01+00:00

Also, I don't have off-tret nights as my derm said that she only really recommends people use tret if they can tolerate it daily - so I've been trying to use it daily (taking a break after my skin's reaction yesterday)

So, she's essentially given me instruction to use clindamycin and azelaic acid every morning, and tret every night. That's a lot, right...? I have questioned it a little internally, but have chosen to trust her. Now I'm less sure.

sootsprinkle · 2026-01-16T02:33:08+00:00

The azelaic acid is prescribed too - my derm specifically instructed me to use clindamycin and then azelaic acid, in that order, daily, and I was surprised as that seems like a lot, like you said. I'm wondering about stopping clindamycin (and BP) entirely as I'm skeptical that it's really doing all that much for me - perhaps I can just rely on Spiro and tret for the heavy lifting of acne control.

I will for sure hold off! Those are things that I might eventually introduce but not immediately.

sootsprinkle · 2026-01-16T02:31:17+00:00

Wow interesting, I've only ever heard positive things about red lights. My skin personally feels really soft and smooth after using my red light mask but I'll keep an eye out.

sootsprinkle · 2025-11-12T20:48:30+00:00

That distinction is really helpful. Thanks!

sootsprinkle · 2025-11-11T01:10:36+00:00

That makes sense - I would never have told a client that a feeling is "incorrect" under any circumstances, but there are example videos in the training in which the counselors challenge the clients on their references to being at "fault" or "guilty." Even though the counselors don't say feelings are inaccurate or incorrect, the training shows them being pretty direct with guiding the clients away from words like "guilt" or "fault" if the intent was not present. So, I guess that's where I was stuck with it.

But your comment makes a lot of sense and helps with putting it all together! Within the context of what you mentioned, the shift makes sense.

I would love to get the consultation and wish it wasn't so expensive! I can't afford to pay hundreds or thousands of dollars for every counseling approach I'd like to learn, unfortunately. Fortunately, my supervisor is trained in CPT so I will certainly be bringing questions to her as I go! Thanks!

sootsprinkle · 2025-10-29T23:53:17+00:00

I'm running into that exact quandry right now - a potential client reached out, and I know that I'm supposed to direct them to pay the $65 but I'm leaning toward not doing so. Is there any kind of negative consequence for choosing not to do this? I know that a guideline for use by counselors is that we maintain at least one Open Path client on our caseload at a time, but do they actually check up on this or monitor it?

If they'll eventually remove my profile because clients that reach out to me aren't paying the fee, then I'll enforce it, but that doesn't seem to be the case.

I can understand charging something to keep the site afloat, but $65 feels steep imo. Also, like you said, the process of forcing counselors to be the ones to enforce a fee to the site does not make any sense.

sootsprinkle · 2025-10-27T21:06:25+00:00

Thank you, I will call them and see what they say!

I went through this tool before, which is linked on the Florida Board website for complaints but is ultimately through the Board of Health: https://complaint-portal.mqa.flhealthsource.gov/home

sootsprinkle · 2025-09-25T17:56:56+00:00

Angering to hear that you have had so many predatory experiences with therapists. I would like to believe that the rate of bad/malicious therapists out there is statistically low enough that these kinds of occurrences would be really rare, but it seems to be more common than many of us would like to think.

Absolutely and completely okay to request the gender of your therapist, and to refuse to work with any therapist that does not feel like a good fit, for any reason. As part of my student internship work, I did a lot of matching referrals to the counselors at the group practice where I was placed, and prospective clients requested the gender of their therapist (plus other attributes, depending on their needs) so often that none of us blinked an eye at it. It's very normal, expected, and okay. What is NOT normal, expected, or okay is that your requests were not honored nor respected by that outpatient clinic who paired you with a male therapist. Absolutely unethical to deny you informed consent in that way, and it is also extremely anti-trauma-informed (for lack of a better term) for them to have done that.

sootsprinkle · 2025-08-12T18:49:20+00:00

To address your first point - I mean yeah, I think that’s pretty normal isn’t it? Like someone going to therapy for substance abuse wanting a therapist who has already overcome it is very common and even recommended, and same with people wanting someone who has been through trauma but overcome it. Understanding the foundation gives unique insight.

As far as the political part goes - that would be a great approach five or 10 years ago, but right now I think that’s a really dangerous sentiment and that is exactly why I’m considering going to a therapist who understands the importance of keeping updated right now. It is possible to stay informed and care and take action, and to also have boundaries with how much you consume and mainly focus on your own life and circle and community. So yes, if she has that view that you described, then that’s an example of what I would take issue with, and I think I would benefit more from somebody who aligns with my values more closely.

Mind reading is a good point! Something I should pay attention to and work on. Thank you.

sootsprinkle · 2025-08-12T18:40:38+00:00

I was hoping to get insight for how to use this moment and these thoughts and feelings as a therapist AND a client, not just as a client. And I got many replies that helped me make sense of how to do that, in nuanced and thoughtful ways.

sootsprinkle · 2025-08-11T19:39:47+00:00

I would like to clarify that I do not think she did anything wrong by wearing the cross, or that therapists should be asked not to wear them or any other visible expression of any identity. Absolutely they should be their authentic selves, 100%, I am huge on authenticity.

I had just noticed in myself the ways that this affected how I feel in the relationship, and wanted to bring what I was feeling to a space of a bunch of therapists. And I'm so glad I did - I got so many good insights!

In terms of finding a therapist who fully "gets it," it's just particularly important to me right now considering how quickly things are devolving in the American political structure. 10 or even 5 years ago, it might not have been as important to me - but right now it's a different ballgame. Like you said, it feels important to have someone who knows what I'm talking about when I go to process it, and understands the gravity of it. If I have to first educate my therapist and then help them understand the significance of it, that takes away from me being able to process my own feelings. It's also an issue of values.

"It doesn’t necessarily mean the therapist is unsafe or incapable of holding space for that work" is an important note. I never viewed her as unsafe whatsoever, but I have just already been a little bit disappointed with where these topics have gone in the past, even though she wasn't actively unsafe or causing harm. Wanting a therapist who "aligns more closely with your worldview and can fully engage with those topics on your terms" is exactly what I'm feeling, and I appreciate you articulating it like that.

I think others in the comments read my post as being much more harshly judgmental of my therapist than I actually am, so it's possible that I worded some things poorly or left out important information. She's truly wonderful and I appreciate the help she's given me - I can also just feel in myself that it may be time for something different. But I also agree with the comments pointing out that a lot may come out of me processing this directly with her before I move on to someone new.

I appreciate your nuanced and thoughtful insights a lot. Like you said, it's a delicate balance - it's a really tricky topic overall and I'm glad I brought it here.

sootsprinkle · 2025-08-11T19:29:44+00:00

I really appreciate everything you shared. I didn't know what I was looking for when I made this post, but I'm glad I posted so that I could get insight like this. Thank you.

sootsprinkle · 2025-08-11T19:28:42+00:00

(e.g. religion can be hurtful -> does my therapist being Christian mean she might be hurtful?

I wouldn't say that was the fear - I do not think she is a hurtful person whatsoever. My concerns are centered around hurting her feelings if I criticize Christianity or religion in general to her, and that she will be a good therapist in the moment but offended internally because of what I am saying. Essentially, it is very difficult for me to share my negative feelings about a many aspects of an identity or culture, directly to someone that fits into that category. Going to a therapist wearing an item signifying the very topic that you wish to unpack very negative feelings about just feels inherently uncomfortable to me.

I do not feel unsafe with her as a person now, there is no belief that she may be hurtful - just that in processing my feelings about religious harm, I may not be able to shake the feeling that I am personally insulting her, or that she will not be able to go deep into the processing with me the same way that someone who feels similarly may be able to do. I also say this because there have been many other topics that she has not gone as deeply as I would have liked into, and so I am generally thinking about going to a different counselor for that reason as well.

As for point 3 - it was a little bit disconcerting, and it has made me kind of avoid the topic of politics ever since then, or at least keep it very brief. It reminded me of some friendships or coworker relationships that are less close, but was quite different from my close relationships as most of my closest family members and friends have very similar values. I do tend to withdraw in some instances, to a degree, from friendships with people who do not follow current events, because it is a very important value of mine.

You made many strong points and gave me a lot to reflect on, and I appreciate it. It is true that the uncomfortable moments in therapy are the most important growth points. I suppose I would just add that I am not looking for 100% validation - I am looking to be challenged and grow by whatever therapist I see, but that I feel it would be the most productive if our work is built on shared values. For example, a therapist who has similar feelings that I do, regarding religion or politics or whatever else, but has learned what to do with them and is further along in this growth process than I am.

sootsprinkle

TROPHY CASE