Cognitive Processing Therapy 1.0

I have explained before that when I run a particularly difficult course outside I tend to set small goals for myself. I run from one telephone pole to the next. "This hill is too steep and too long, only 50 more meters to go. Made it." "I am sucking wind, and my legs are burning, 50 more meters." "It is so hot out here, and I am so thirsty; 50 more meters." When a run goes by 50 meters at a time, it becomes doable. It is one small piece at a time until the whole run is finished. I have used that analogy many times when speaking with my therapist about my progress and goals. She turned it on me one day.

In May, she asked me about taking the next step toward the upcoming telephone pole. She was referring to trauma-focused therapy. I kind of panicked, fell of the wagon, buried myself in a deep hole, and self-sabotaged for several months. I don't think it was intentional so much as protective. Trauma-focused therapy would require that I actually look at the trauma, with feeling. I would rather be stoned to death than feel that! I have avoided actually experiencing this for YEARS.

In September (I think), my therapist and I had another discussion about moving forward. I used another analogy from my running experience. One of the many running courses I have in my small town of Factoryville takes me down College Avenue, past Keystone College, and into LaPlume. There is a stop sign at the corner of College Avenue and LaPlume Road (the two-mile mark), and sometimes I will stop running to decide if I am going to turn around and run back or keep going. The mileage difference is miniscule. Turning back means I ran a flat 4 miles. If I continue on past the stop sign, then I will run about 4.5 miles. The difference is this: that extra .5 miles is a steep hill. I feel frustrated when I choose to turn around and take the easy way home, but I feel defeated when I keep moving forward and cannot run up the entire hill. 

My therapist pointed out that I was standing at the stop sign. Fear of failure and defeat, or maybe just fear had me frozen. I was encouraged to start moving up the hill (notice I did not say running). She told me that it did not matter how I made it up the hill as long as I made it to the top. I could run, walk, or crawl; I could not stop, though. 

I was asked what moving forward would look like. I thought about it for a minute and told my therapist this: "When I am at the gym working out, my trainer may give me a lift I have not done or more reps or rounds than I would typically do. I will usually look at him and ask if he has a weight suggestion." Trauma therapy is the exercise. What method or how to go about starting is the weight. Our discussion was my way of saying that I was willing to start, but I had no idea what that would look like. 

 A couple weeks after that discussion, we decided I would start with Cognitive Processing Therapy rather than EMDR. My therapist said that she would review some material before starting. In my mind that meant I had some time. Exactly one week later, on October 10th, I believe, I found myself with papers in hand that said, "CPT session one." 

Session one was "easy." It was more of an explanation of what to expect and what was expected. However, I found myself feeling extremely anxious and overwhelmed for two reasons: 1. Avoidance is not tolerated. There is no choice but to move through everything. Avoidance gives me a sense of control. If I am not in control, then I react in a way that allows me to feel in control. None of these behaviors would be considered healthy or helpful during this structured therapy. 2. Assignment number one was to write something called an impact statement. I would have to write the reasons why I believe I am to blame for what happened and how that has changed my perspective on myself, others, and the world across several areas. This assignment did not actually seem too difficult at first. Then, as I was walking out the door, my therapist said, "Oh, you will have to read your impact statement out loud in the next session." 

Think about this a second. You believe you are solely to blame for something that happened. You come up with every reason why that belief is true, including every detail (without actually sharing the narrative), and then you share it with someone else who has potential to think in their head (or maybe even say out loud), "Yup, you definitely brought that on yourself." Having already had the experience of a professional asking me what I did to cause it, this is not just an irrational fear. I am convinced that anyone who knows what happened would believe I am the responsible person, including my therapist.

Despite the fear, session one is in the books, and there is no turning back for the flat, easy 4 mile run. I am officially on my way up the hill.