Complex posttraumatic stress disorder (PTSD) misdiagnosis happens out of ignorance. Although many people are now aware of the prevalence of sexual abuse, but not nearly enough people are aware of the lifelong effects of the abuse. Unfortunately, this includes some mental health professionals who can end up missing the diagnosis of complex posttraumatic stress disorder (PTSD) and instead give the person a misdiagnosis.

I wasn't actually diagnosed with posttraumatic stress disorder (PTSD) when I started therapy. So years into my first therapeutic relationship I realized we were going nowhere -- fast. I'd gotten into therapy to learn how to live as a chronic patient, but what we were doing was talking and talking and talking about my trauma and the enormous fears I carried. I was mentally and physically deteriorating at a frightening speed. I needed to know how to find a good PTSD therapist.

Recently, I’ve spoken to two survivors who are just discovering (after years of invested time and work) that their therapists are not equipped to work with posttraumatic stress disorder (PTSD).  This breaks my heart to hear. You’re struggling enough to cope through the day without being stuck in a treatment approach that can’t help you reach your recovery goals as quickly as possible. But the two stories I recently heard don’t surprise me. In fact, it was my story too.

People deeply involved in any way of looking at the human world tend to take that worldview with them wherever they go. So it is both with those committed to a religious tradition as well as those committed to evidence-based psychology and psychotherapy. Each of us will tend look at serious human problems from our respective viewpoints. This can get confusing. An excellent example of this came up recently with a question posted to Google+  for general comment by HealthyPlace.com: Is forgiveness an important component of healing from trauma? I suspect that individuals committed to both worldviews reacted to this question in fairly predictable ways. I know I did. My reaction was immediate: "Important? Absolutely not. Useful? It can be, but not in the way religious people tend to think." As I discussed the matter with a thoughtful and articulate individual, a richer picture emerged which is worth bringing to this venue, and elaborating on, for many reasons.

It's winter where I live. Apparently it's winter lots of places right now - a time for dark days and dark thoughts. I know a lot of people who are in trouble right now, and tempers are just a bit short, mine included. And now we have to deal with horses. It's about "healing" PTSD, you understand. Oh, you don't? Yeah, I have the same problem.

In my previous post, I looked at the question of whether or not your therapist was doing "the correct thing" in treating your PTSD. I suggested that this is an ambiguous question, for what is correct from her or his point of view is usually related to the treatment model they are using, while for YOU it is not about that at all. So, we really have two questions to look at. I suggested previously that assessing whether or not your therapist was doing the correct thing was basically beyond the capability of most psychotherapy clients, with the probable exception of a client who was themselves a psychotherapist, and who uses the same treatment model. Finally, I suggested that it was actually quite sufficient for you, as the client, to deal simply with YOUR part of this question. That question, as I have thought of it, forms the title of this post: Is your PTSD therapy giving you the results you want?

A reader recently asked me a very important question. Speaking of her therapist, she asks "How do I know that what he is doing therapeutically is the correct thing?" This is a surprisingly complex question. I will point out the major issues to address in coming up with an answer, then describe my own preferred way of dealing with this question. However, there are two aspects to consider here - your therapist's viewpoint, and yours. It is quite possible for your therapist to do the "correct" thing, but not to get the results you want. Because each of these considerations deserve careful thought, I will address my reader's question in two posts. This first one  will consider how to think about your therapist. We must begin by asking: What determines "correct" for your therapist?

Previously, I proposed that trust of your therapist is necessary if you are to achieve the success you hope for when engaging their services (Therapy's First Obstacle: Trust My Therapist? No Way!). At the least, you hope for reduction of the undesirable trauma and/or PTSD symptoms which bring you to therapy in the first place. You should also hope to regain at least some of what you've lost because of the intrusion of these symptoms into your daily life. Working collaboratively and cooperatively on these important, challenging goals with your therapist is the only reasonable plan for you to adopt if you want therapy to work.

Effective psychotherapy requires a substantial degree of trust, which can only occur when the client-therapist relationship feels sufficiently safe to both parties. With victims of psychological trauma, achieving this sense of safety and trust can be a truly difficult barrier to productive therapeutic work. Let's look at some of the reasons for this. But, first - why do this? Because it is all but impossible to solve a problem you don't understand, and this problem must be solved. That this is possible is verified by the thousands of people who have actually done it, each in their own manner, but all in the same general sorts of ways. It is important to see a path to the mountain top, if that is where you wish to be. Let's look at how and why that path can be hard to find.