Saturday, April 13, 2013

How can I afford to heal my Complex PTSD? I don't have the money for therapy.

Today I looked at the search terms that have led readers to my blog recently, and the newest term on the list was "financial aid for healing complex ptsd."  This term has appeared several times in the past, and I have not done a good job of addressing it in any post because finances can be an overwhelming issue. 

As I've mentioned, I'm lucky because I'm old and on Medicare, and now Medicare pays about 55% for outpatient therapy.  My backup insurance pays the rest. In the past, Medicare paid partial coverage for treatment if a person was hospitalized but paid nothing for outpatient therapy unless it was done by a psychiatrist.  Since the Iraq war, however,  research on PTSD and its symptoms and the return of people from the battlefield who suffer from PTSD have come to the attention of the public, and interested groups have put enough pressure on our government to include Medicare coverage for outpatient treatment by various types of qualified mental health professionals.  As far as I know, this is where the matter stands at present. 

The problem, as you may be aware, is that people who do not qualify for Medicare are often not adequately covered by their private insurance.  Many insurers, to cut costs, just provide minimal mental health coverage, so even if a person has insurance that provides good coverage for physical ailments, the insurance may not help much in covering the expense of mental health therapy.  Or the insurance may provide coverage that is good but provide it for just a limited number of visits.  As you know from reading my blog posts, Complex PTSD is not, in my experience, a disorder that can be healed in fifteen visits!  A condition like C-PTSD builds over a long period, and it takes a long time to heal.  That's the bad news.

The good news is that if one is creative, sometimes help can be found in places where few people think to look.  For example, if you are a victim of domestic/sexual violence, the person who violated you can be made to provide restitution as part of his or her punishment.  When I reported my husband for child abuse in 1981, for example, the court ordered him, as a condition of his probation, to pay for therapy for my daughter and me.  He, through his behavior, had damaged our lives, and he needed to do whatever was possible to undo the damage.  That was the rationale for making restitution a part of his sentencing.  Paying for our therapy was part of his act of restitution. 

Of course, healing takes time, and paying for our therapy was not sufficient to undo the damage, but we got a start on undoing the damage.  That helped.  Later, when I was working, my health insurance helped me pay for therapy.  My daughter was out of luck, for the most part, because the work she did was not the sort that provided good insurance.  She was largely dependent upon public clinics that had sliding fee scales when she needed help.  As a result, she was not able to access long-term therapy as I was.  Also, she was not as persistent as I was in getting help and in getting a diagnosis that led to long-term help.  Her therapy was sporadic and was not specific to helping her heal PTSD. 

One source of help that is often "lost in the shuffle" is financial help through a victims' fund.  Some cities and states have funds for victims of crimes, and one use of these funds is to pay for therapy.  In order to access the fund, however, a person has to be able to prove that he or she has been victimized.  That normally means that a woman, for example, has had to press charges against her abuser and the abuser has been found guilty of the charges.  If a victim has not pressed charges and is not legally a victim of a crime, then chances are, the person cannot utilize this source of funds to get help.  This is one good reason, for instance, for a woman who has been raped to press charges against the perpetrator. 

In the case of a person who has been sexually abused, the abuser can be sued.  That is a long and extremely painful process for the victim, but if the victim wins the suit, then he or she can use some of the money to pay for therapy.  The newspapers have published many accounts lately of suits brought against the Roman Catholic Church by people who have been sexually abused by clergy.  One purpose for the settlement money is to undo some of the damage to the bodies and souls of the victims.  However, in general, people who have not endured this sort of abuse have absolutely no understanding of the extent to which the victims have been damaged.  Money for therapy helps the victim, but it will never restore the victim to his or her condition before the abuse.  For those who regard the clergy as God's representatives on earth, being abused by a clergy member is often akin to being abused by God, and many victims of this abuse lose all faith in God as a result.  Abuse by a clergy member inflicts deep damage on a person's soul.  But, then, any sexual abuse damages the soul. 

Finally, public agencies may be helpful in providing therapy.  Generally, however, because many such agencies rely on part-time people or interns to provide therapy, a client needs to be able to advocate for himself or herself so that he or she gets the appropriate help.  This means that the person seeking help needs to be knowledgeable about his or her condition.  To get the knowledge necessary, the person needs to be aware of symptoms and needs to perhaps come up with a tentative diagnosis, even.  The person must keep the information in mind as he or she visits the agency or clinic, and if it looks as if the treatment is going in a wrong direction, the person must call the clinician's attention to that possibility.  Nicely, of course.

Complex PTSD can be misidentified and mistaken for other disorders, so if you suspect you suffer from C-PTSD, you  must advocate for yourself and not allow yourself to be treated for some other condition until or unless you have been satisfied that the diagnosis is accurate.  The fact is that some public agencies receive funding for treating some specific conditions, and sometimes clinicians will try to shove people into those diagnoses in order to justify treatment.  That happened to me at one time when I wanted to work in guided imagery.  I was asked to sign a paper stating that I would discontinue abusing substances as a condition of receiving the help with guided imagery.  Since I had never abused substances, I was not about to sign a paper stating that I would discontinue doing something that I had not done in the first place.  As a result, I was not able to participate in the guided imagery.  Better that, however, than risking that my file someday be shared with somebody who would have me tagged as a substance abuser, which I have never been.  The information could have kept me from getting employment or from participating in certain programs.  In this age of technology, you need to be careful when you sign something! 

As you can see, getting help paying for therapy is fraught with pitfalls right now.  If you need help and your insurance is inadequate or you are not insured, just keep chipping away at the logical sources--mental health clinics, courts, victims' funds, and so forth.  Don't give up.  Most importantly, though, educate yourself.  Read all you can find that seems appropriate for your particular history, and talk to people who have been through similar abuse experiences.  Networking can bring about miracles!  Join a support group if there is one in your location.  If you keep working and advocating for yourself, one day you will get what you need.  As the Brits said during WWII, "Keep calm and carry on."  The Allies won the war, and you, too, can come out a winner if you just carry on.  It's taken me almost thirty years to find effective therapy, so don't give up! 

4 comments:

  1. Great posts lately. This one is particularly helpful since so many of us are pressed for money and help is sooo expensive. But in the long run, it's such a good investment and mental health is a life saver. Thanks for great information.

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  2. Your blog is astounding! GoD Bless you for sharing your experiences and knowledge. You are an incredible writer!! I am sharing your info on EMDR with a support group on Facebook. Thanks again!! You should be very proud. This is quite an accomplishment!!!

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    1. Hi, Char! I'm so glad that you have found my blog helpful. The good news is that now Medicare pays 80% of the bill if you see a Medicare-qualified therapist. My therapist is a clinical psychologist, so she is reimbursed by Medicare. For people on Medicaid, however, the picture isn't so bright. Also, since C-PTSD is not an official diagnosis in the DSM, it's hard to find a therapist who recognizes it as a real condition. My therapist seems to have had no problem with coding and getting reimbursed.

      Regarding EMDR: If you look on the official EMDR web site, you will see that practitioners qualified by the EMDR institute emphasize the importance of adequate preparation before starting EMDR treatments, particularly if the person to be treated has developed symptoms of dissociation--as MANY people with C-PTSD have! In my case, I spent three years working in Ego State Therapy/Internal Family Systems therapy just to get ready for EMDR. By the time my therapist said I was ready, I was in good enough shape to need a minimal number of EMDR sessions. The trauma resolution that comes with EMDR therapy is not the same as the resolution that came with the ego state work, and the two types of trauma resolution combined really helped me be where I wanted to be. So I was happy that I had hung in there for five years. Now I feel that I experience life pretty much the way most women my age seem to experience life, and that's what I wanted to achieve. Also, my ptsd symptoms are pretty well alleviated--no more flashbacks, dissociative episodes, derealization, depersonalization, etc.

      If I can be of further help, please just send me an email message to jeanfairgrieve15@gmail.com. All my best wishes to you and the people in your support group! I'm so happy that you wrote! Jean

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  3. In 1985 I was involved in a Life altering MVA. I wad left paralyzed, a widow & 3 children 5 & under at 22. It had taken me thirty three years top accept that I have never dealt with it I just buried it deep in a borded up pit in side of me. I have been told by more than one dr.. I never dealt with this tragic event. I am finally starting to believe it. I don't have to be the strongest person in the crowd cuz it isn't real anymore. Never was. Thanks for helping me to see that . Where I go now I'm not sure but not back to where i have been for 33 years.

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