CPT introduced the concept of ‘stuck points’ to me and at first I was completely lost, confused, skeptical, and thought I could never figure it out. I was amenable to the idea that I may be stuck, that my brain may have automatic thought patterns that get me in trouble with unwanted symptoms. I reluctantly admitted that FINE I do have mental illness, that my anxiety/depression from this c-ptsd is no longer something I can hide or want to hide and I’m willing to listen if these new counselors SWEAR, I mean, cross their hearts and hope to die swear that they know how to help me out this hell hole I am trapped in, well then I will fess up.
I am a mess. I am stuck. I have always been a mess. I’ve pretended and avoided and dealt with pain and panic and terror all of my life.
They say there is another way to live. They say I can get UN-stuck. Hmmm. Yeah right, I think. But I’m curious. So I listen.
Here is what they explained to me about stuck points.
“Basically, stuck points are conflicting beliefs or strong negative beliefs that create unpleasant emotions and dysfunctional or unhealthy behavior. Stuck points can be formed in a couple of different ways: 1. Stuck points may be conflicts between prior beliefs and the traumatic experience. 2. Stuck points may also be formed if you have prior negative beliefs that are confirmed or reinforced by the traumatic experience.”
That’s where the confusion set in. Prior beliefs? What does that mean? I bravely asked my counselor in front of the group, and she explained that this means our beliefs prior to the traumatic experience. We were supposed to be comparing our thoughts, feelings and beliefs from before and after the traumatic experience. Ohhh…wow. OK well that would make sense if I had only one, and if I could remember a life before or without trauma/abuse. But I can’t. My youngest memories at age 3 already include sexual and other abuse. I have NO PRIOR beliefs. All of my beliefs were formed and shaped during trauma. I expained this to the counselor, and saw the room react. Even in a room full of trauma victims, I managed to shock them, and invoke pity, yay me.
So my counselor had to explain stuck points differently for me to understand.
“Stuck points are thoughts that keep us from recovering. Unbalanced, extreme thoughts we say repeatedly, automatically to ourselves everyday, often in times of stress, and usually when we exhibit avoidance or otherwise self-destructive behaviors.”
I asked her if she meant negative self-talk? Like, I’m a freak, I’m worthless, I can’t do it? She said those can be good places to start, but that stuck points can be about anything and anyone, and we may not recognize it as negative self-talk, but only as self-talk. Hmmm. So I was sent home with a blank stuck point log and told to start listening to myself and which phrases pop up often. It was difficult at first, these phrases were so ingrained that I did not know I was even thinking them. It is getting easier to hear myself now, pull out my log and jot another down. And then sigh. Before I’m so stuck its difficult to see how to get past any one of these let alone this entire sheet of them. A list like this, showing you exactly how messed up you are, is not an easy thing to own. This is not a perfect score and I no longer have any way to run or hide. I get angry and nauseous every time I look at it, and yet I keep somehow looking at it. Because I want to start crossing them off. Blasting them away with maniacal laughter and awesome laser sound effects. Some day…
Well, Here’s my own personal list so far, this is still growing and being refined:
- People will eventually hurt me
- I can’t get too close to anyone
- No one will understand me
- All doctors make mistakes and may make it worse
- People live double lives and can’t be trusted
- Everyone lies
- I can’t experience my feelings until its safe
- Its not safe to feel emotions until I’m alone
- They will think I’m a freak if they see or hear me
- No one will accept the real me
- I’m a burden to others
- I make others uncomfortable and cause them too much pain
- I can’t do this by myself
- I can’t protect myself
- I’m not good enough
- I am too flawed, damaged and broken to be mended or ever fit in and have a normal life
- Everyone I love leaves me
- I’m no fun unless I fake it
- I can’t count on anyone
- I’m better off alone
- It’s pointless to try, it doesn’t matter anyway
- If I don’t do what I’m supposed to do, bad things will happen
- If I don’t control the environment someone will get hurt
- If I don’t think of everything no one else will do it, and something bad could happen
- If let others know what I’m thinking or feeling they could use it to hurt me
I’ve found great resources online that helped me when I was confused on my homework, I’ve included some excerpts below from this link Stuck Point Help Sheet from Ryerson
Below are examples that are commonly misidentified as stuck points:
Not a stuck point: “Trust”
Why not? This is a concept, not a thought. It is not specific, and you need to identify what the person thinks about trust. In this example, you might ask him/her what about ‘trust’ is a problem.
Possible related stuck points: “I can’t trust anyone.” “If I let anyone get close to me, I will get hurt.” “I can never trust my judgment.”
Not a stuck point: “I am nervous whenever I go on a date”
Why not? This is describing a feeling, not a thought. In this example, you might ask what patients are telling themselves about the date to help them identify potential stuck points.
Possible related stuck points: “If I go on a date, I will get hurt.” “People always take advantage of me.”
Not a stuck point: “I fight with my daughter all the time”
Why not? This is describing a behavior, not a thought. In this example, you might ask more about the client’s thinking before, during, and after a recent fight with her daughter to identify possible stuck points.
Possible related stuck points: “I don’t mean anything to her.” “I must be in control to keep her safe”
Not a stuck point: “I witnessed people die”
Why not? This is describing a fact, not a thought. In this example, you might ask for the client to describe the impact of witnessing others die. What thoughts did he have at the time, what thoughts does he have now? Or after that statement asking – And, therefore?
Possible related stuck points: “It was my fault that people died.” “I should have done something to prevent it.”
Not a stuck point: “I don’t know what will happen to me” or (“What will happen to me?”)
Why not? This is a question about the future. In order to find the stuck point in this example, you might ask clients when they ask themselves that question, what is the answer they come up with? What is the meaning of that answer?
Possible related stuck points: “I will not have a future.” “I am not deserving of good things in my future”
A few reminders about good stuck point structure:
- If you are struggling, put a statement into the “If…., then…” format if possible and fill in the blank. For example, “If I had seen the mine, then Joe would not have died”. On the impact statement, you can underline stuck points and put into “if/then” format on the Stuck Point Log.
- Stuck points are typically black/ white statements, and use extreme language. Extreme language can sometimes be hidden, for example, sometimes when a patient says “It was my fault” they really mean “It was ALL my fault” – the second can be easier to get some movement on.
- Stuck points are harder to challenge when they are too vague. Make it more specific by asking, “How did you come to this conclusion? For example, “I trust no one” can be refined to “If I trust others, then I’ll get hurt.”
Examples of Stuck Points
- If I had done my job better, then other people would have survived. (assimilated)
- Other people were killed because I messed up. (assimilated)
- Because I did not tell anyone, I am to blame for the abuse. (assimilated)
- Because I did not fight against my attacker, the abuse is my fault. (assimilated)
- I should have known he would hurt me. (assimilated)
- It is my fault the accident happened. (assimilated)
- If I had been paying attention, no one would have died. (assimilated)
- If I hadn’t been drinking, it would not have happened. (assimilated)
- I don’t deserve to live when other people lost their lives. (over-accommodated)
- If I let other people get close to me, I’ll get hurt again. (over-accommodated)
- Expressing any emotion means I will lose control of myself. (over-accommodated)
- I must be on guard at all times. (over-accommodated)
- I should be able to protect others. (over-accommodated)
- I must control everything that happens to me. (over-accommodated)
- Mistakes are intolerable and cause serious harm or death. (over-accommodated)
- No civilians can understand me. (over-accommodated)
- If I let myself think about what has happened, I will never get it out of my mind. (over-accommodated)
- I must respond to all threats with force. (over-accommodated)
- I will go to hell because of the things that I have done. (over-accommodated)
- I am unlovable. (over-accommodated)
- Other people should not be trusted. (over-accommodated)
- My hypervigilance is what keeps me safe. (over-accommodated)
- If I have a happy life, I will be dishonoring my friends. (over-accommodated)
- I have no control over my future. (over-accommodated)
- The government cannot be trusted. (over-accommodated)
- People in authority always abuse their power. (over-accommodated)
- I am damaged forever because of the rape. (over-accommodated)
- I am bad because I killed others. (over-accommodated)
- I am unlovable because of [the trauma]. (over-accommodated)
- I am worthless because I couldn’t control what happened. (over-accommodated)
- I deserve to have bad things happen to me. (over-accommodated).