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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 29. This is the beginning of the thread.
Posted by deirdrehbrt on May 27, 2003, at 21:25:04
Hi.
(I accidentally posted this in Psych-Babble. Sorry, but I'm not used to how this board works yet.)
I've been reading in the background for a little while, and thought I would ask for some advice / encouragement if anyone has had a similar experience.
I've been being treated for Bipolar with psychotic symptoms, and Borderline. Recently, my therapist and Psychiatrist have come to an agreement that I have DID.
I'm wondering if anyone has ever been in a situation like this. Did you remain on meds, were they changed? How did therapy change? I feel like I'm going somewhere that I've never been, and it's really scary. The way things are is already scary, but I'm familiar with it. Now I'm going somewhere that I haven't been. If someone has been somewhere near here before, I would very much like to know what your experience has been.
Posted by Pfinstegg on May 27, 2003, at 21:58:11
In reply to DID diagnosis after other diagnoses., posted by deirdrehbrt on May 27, 2003, at 21:25:04
And I answered you in Psychobabble- in case we don't get redirected, my reply is there!
Pfinstegg
Posted by judy1 on May 28, 2003, at 11:02:04
In reply to DID diagnosis after other diagnoses., posted by deirdrehbrt on May 27, 2003, at 21:25:04
My shrink is actually working with both dx- bipolar and DD-NOS (similar to DID). There is a lot of overlap- a manic episode can look like a distinct personality, and once you throw in a history of abuse and dissociative symptoms (and SI?), I can see why the leap is made. My therapist would most likely stay in the dissociative disorders since that is what she mainly treats. If they are both certain of the DID dx then you most likely would not take meds but rather therapy (which is what I prefer anyway). For me therapy is a way to learn new coping behaviors which I find really helpful. We don't delve in the past because that is painful and I don't find it that productive. Sorry to ramble- but I guess the point I was making is the biggest change would be meds (no mood stabilizers) and I wouldn't think you would miss that. take care, judy
Posted by Dinah on May 28, 2003, at 14:44:51
In reply to DID diagnosis after other diagnoses., posted by deirdrehbrt on May 27, 2003, at 21:25:04
Hi Deirdre,
I think Pfinstegg's therapist has a wonderful explanation of the dissociative process. I've printed it out to show my therapist.
From all I've read I think Judy is probably right about medications. I think therapy is the main treatment of dissociative disorders. But that doesn't mean you won't continue to take any medications that you need for any other co-existing problems you might have, anxiety, depression, etc.
As far as the direction of therapy. Most therapists seem to follow a post-traumatic stress disorder type model. A lot seem to favor aiming for integration, while others feel that cooperation is sufficient. I imagine the first priority would be to reduce the number of problems that the dissociation causes, such as losing time. I've read a lot about it because, while I don't meet the criteria for DID, I am somewhere on the dissociative spectrum.
I can recommend a couple of books that are pretty good at explaining things in a non-threatening way. One is "The Myth of Sanity: Divided Consciousness and the Promise of Awareness" by Martha Stout. Another is "The Stranger In The Mirror" by Marlene Steinberg. Maybe someone else can recommend some others.
Posted by deirdrehbrt on May 28, 2003, at 20:43:28
In reply to Re: DID diagnosis after other diagnoses. » deirdrehbrt, posted by Dinah on May 28, 2003, at 14:44:51
Judy and Dinah,
Thank you for your posts. I am still fairly new with all of this, and really appreciate your help. A couple of years ago I was dealing with divorce and a possibly ill daughter. I spent a year in therapy dealing with 'only' depression brough on by these things. I managed to use humor to keep my therapist at bay. We could talk about the divorce or my daughter, but anything beyond that was deflected.
Now I have to deal. I hope my attitude is changing, and I am really looking for help. Thank you so much for yours.
Dee.
Posted by Dinah on May 29, 2003, at 19:06:02
In reply to Re: DID diagnosis after other diagnoses. » deirdrehbrt, posted by Pfinstegg on May 27, 2003, at 21:58:11
Pfinstegg, I don't mean to be intrusive, but something you said really stuck in my mind:
"The very hardest work that I have to do in therapy is to allow these two entirely different feeling-states to co-exist more and more, as I am able. I would rather do anything else than this, but I do trust that my therapist is right when he says that it is what I need to do. He wants all of me to be in the room with him."
It's really got me wondering. Is that even possible? With myself, I find that my two ego states or feeling states or whatever can't occupy the same space at the same time. Or, in other words, only one can have the consciousness at any given time. My rational self can access my emotional self to greater or lesser extents, but for all of me to be present at once seems like a logistical impossibility. Is it a matter of stretching consciousness? Or how is it even possible as a goal? Under the laws of physics or whatever.
If you have no idea at all what I'm talking about, never mind. I'm not altogether sure I do either. :) And if it's too painful or personal feel free to just ignore my question.
Dinah
Posted by Pfinstegg on May 29, 2003, at 20:08:23
In reply to Re: DID diagnosis after other diagnoses. » Pfinstegg, posted by Dinah on May 29, 2003, at 19:06:02
Not intrusive at all, Dinah, as I feel both protected and safe on PB. You're right about the immense difficulty of trying to be in both feeling-states at once. I think the reason it feels impossible is that each state is thought to be in a slightly different part of the brain- the neuronal circuits reverberate freely within each part, but there is little or no cross-connection between the different parts. According to my analyst, this is the neurological basis of dissociation. When it is extreme, it could be called DID, but the name really does not matter- the process of separating off good from painful experiences is what everyone does in response to trauma.
His idea is that we are working to grow some new connections between the separate parts. As you know, I am at the very beginning of this process. So far, I just present either one state or the other; the "good" one tends to feel happy, confident, loving and easily able to verbalize. The "bad" one feels unlovable, unloving, angry, detached and has a hard time speaking. What he keeps doing is, when I present one feeling-state, he reminds me that the other one is also there nearby. It's just EXASPERATING- the last thing I want to hear about- but I do see that he is aiming for me to be more aware of these two states simultaneously. I am not really able to do it, but, later on, when I have time to think about it in the evening, I can recall how I might have flipped back and forth between the two states, and can try to contemplate having them both in mind at the same time. That's in fact what I'm trying to do as I write you!
If you are interested, I'll try to let you know if I am learning to do this as time goes along. One thing he said today which fascinated me was that the so-called "bad" part needs to learn to trust the therapy process enough to allow itself to be consoled and comforted, just as the "good" part automatically does. God, this is just all mind-blowing!
Pfinstegg
Posted by Dinah on May 29, 2003, at 21:04:50
In reply to Re: DID diagnosis after other diagnoses. » Dinah, posted by Pfinstegg on May 29, 2003, at 20:08:23
It sounds fascinating and instructive. I'd love to hear if you are able to achieve it. It's not even something I can think of considering, as it seems so far from physically possible. My therapist speaks of integration of my rational and emotional self from time to time, but as much as I trust him, that just doesn't seem like a possible or even a worthwhile goal.
I like your therapist's description of the neurological basis of dissociation. Since my ego states are my emotional self and my rational self, it would tend to make perfect sense to think of it that way. I know those parts of the brain have a certain degree of disconnect anyway, just exaggerated in my case.
Does your analyst work with dissociation a lot? He sounds very comfortable with the ideas involved.
Posted by Pfinstegg on May 29, 2003, at 21:25:05
In reply to Re: DID diagnosis after other diagnoses., posted by Dinah on May 29, 2003, at 21:04:50
Yes, he does. He says he prefers to work with patients who have the more severe problems, and has worked a lot with DID, and PTSD from all sorts of childhood abuse, trauma and neglect.. He is beginning to publish some of these thoughts, with case histories of patients he has treated; frankly, even though they make a lot of sense, I don't think I have ever come across these ideas in anything I have read or heard before- have you?
I haven't learned to do what he's suggesting yet, either- I'm just trying to at this stage! On a slightly different note, I have always thought that the "fit" and sense of connectedness between therapist and patient is one of the most powerful forces in helping people get better. If you have that, maybe you just automatically begin building these internal bridges, because you do feel so safe. I was thinking of the relationship which you have with your therapist, which sounds like a very strong one.
Pfinstegg
Posted by deirdrehbrt on May 29, 2003, at 22:30:38
In reply to Re: DID diagnosis after other diagnoses. » Dinah, posted by Pfinstegg on May 29, 2003, at 21:25:05
Dinah and Pfinstegg,
When reading what you've written about your ego states, and the 'rational' and 'emotional' states, I'm reminded of a book by Marsha Linehan. It is the "Skills Training Manual for Treating Borderline Personality Disorder". It is one that I have using with my therapist. What strikes me about it is that it deals with the dichotomy of reasonable mind and emotional mind. Where these two meet is what is called wise mind.
Borderline people tend to stay in either emotional mind or reasonable mind, and part of the goals of treatment is to stay within wise mind more often. Wise mind can reason, and wise mind can feel. It is the only place where both co-exist.
I hope this helps you a bit.
Dee.
Posted by Dinah on May 29, 2003, at 22:30:48
In reply to Re: DID diagnosis after other diagnoses. » Dinah, posted by Pfinstegg on May 29, 2003, at 21:25:05
No, I don't think I've come across the concept expressed like that. And I've done a *lot* of reading. All the more reason for him to publish his work. Some of the dissociation literature is a bit scary. A sensible low key approach is always appreciated.
I don't quite know what my therapist's overarching plan for me is. He's hard to pin down. And believe me, I do ask. Something about reparenting and a corrective emotional experience. He seems to address whatever state I present myself in.
Posted by Dinah on May 29, 2003, at 22:44:08
In reply to Re: DID diagnosis after other diagnoses., posted by deirdrehbrt on May 29, 2003, at 22:30:38
Hi Dee,
It does help, and it's another reminder to me to dig out my skills manual and try again to apply it more systematically.
I just can't really picture myself having good integration of those aspects of me, or even wanting to. As Pfinstegg said, there is a certain amount of good reason to keeping them separate.
Maybe I'll read again.
Posted by Dr. Bob on May 29, 2003, at 22:46:11
In reply to DID diagnosis after other diagnoses., posted by deirdrehbrt on May 27, 2003, at 21:25:04
Posted by Pfinstegg on May 28, 2003, at 22:34:18
In reply to http://www.dr-bob.org/babble/20030525/msgs/229814.html
Yes, I agree- the scariest part is trying to come to terms with the fact that the same people who loved you also harmed and damaged you. I think the idea, which my therapist believes in, of separate or "parallel" brain processing of these so different experiences is very useful in understanding how we managed to survive these experiences- and also for understanding the depression, anxiety and rapid shifts of consciousness which abuse survivors have. To describe my own experience with trying to integrate these different feeling-states in therapy, I find that one part of me- the part that felt loved- does not want to get contaminated (or destroyed) by the part that was neglected and abused. And, strange to say, the abused part does not want to be contaminated (and possibly eliminated or disavowed) by the loved part! I am much more familiar with the loved part, and was really astonished to discover that the unloved, abused part has an entirely different agenda of its own! Now that I know this, I can see that it is so much better, and easier, to keep them separate from one another. The very hardest work that I have to do in therapy is to allow these two entirely different feeling-states to co-exist more and more, as I am able. I would rather do anything else than this, but I do trust that my therapist is right when he says that it is what I need to do. He wants all of me to be in the room with him. It's not the kind of therapy where you come out of a session feeling better, necessarily- lots of times I barely make it out of there. But I also find that something wonderful is occuring- more of me trusts him, more deeply, and my fears and terrors are decreasingly slowly but steadily.
I am not very far along in this, yet, but I hope what I have said will give you confidence in your own journey towards healing and peace of mind.
Pfinstegg
Posted by Dr. Bob on May 29, 2003, at 22:58:25
In reply to Re: DID diagnosis after other diagnoses., posted by deirdrehbrt on May 29, 2003, at 22:30:38
> When reading what you've written about your ego states, and the 'rational' and 'emotional' states, I'm reminded of a book by Marsha Linehan. It is the "Skills Training Manual for Treating Borderline Personality Disorder".
I'd just like to plug the double double quotes feature at this site:
http://www.dr-bob.org/babble/faq.html#amazon
The first time anyone refers to a book without using this option, I post this to try to make sure he or she at least knows about it. It's just an option, though, and doesn't *have* to be used. If people *choose* not to use it, I'd be interested why not, but I'd like that redirected to Psycho-Babble Administration:
http://www.dr-bob.org/babble/admin/20020918/msgs/7717.html
Thanks!
Bob
Posted by deirdrehbrt on May 30, 2003, at 17:25:32
In reply to Re: DID after other diagnoses. « Pfinstegg, posted by Dr. Bob on May 29, 2003, at 22:46:11
Hi again,
I understand what you (Dinah and Pfinstegg) are saying about dissociation, and being fully present in the therapist's office, etc. I have a difficult time with injury and illness; I right now have a second degree burn that I can't feel. When I shower, I often find injuries that I have no recollection of having gotten. I've been hit across the face with a baseball bat and only felt the pressure of the strike. I had a bloody nose, loose teeth, torn up lip, etc.
I also experience the ability to separate emotion from reason. I usually react rationally, but on occasion, emotion completely takes over. In either case though, I know what is happening. I would very much like it if this was the worst of it. It isn't though. The symptoms of DID are at times terrifying.
One experience, perhaps the most scary, was when I was told about the time that I held my oldest daughter down by her throat, screaming at her to 'change her attitude'. I have gone out with a friend to a theatre production, and have absolutely no memory of ever being in that theatre at all. When I was working as an engineer, I had completely built a piece of equipment, but have no memory of it. I went to a sandwich shop and was asked if I wanted my usual. My 'usual' wasn't my 'usual' and the person who asked about this 'new usual' knows me from elsewhere. In a near-by town, there are some people who know me by an entirely different name. I have been called by other names in my own town.
It's very confusing, and maybe helps to illustrate the extent of dissociation that some people experience. It's scary, I pray that I'll never hurt anyone, and don't think I would. Having to remind yourself to treat a wound that you don't feel is strange. It is strange work.
Dee.
Posted by Pfinstegg on May 30, 2003, at 21:51:23
In reply to Re: DID after other diagnoses. « Pfinstegg, posted by deirdrehbrt on May 30, 2003, at 17:25:32
Hi Dee.. what you have described is such a lot to cope with. I hope you will find the board here a good and unfailing source of support, as so many others have. Do you think that you have a therapist who is truly understanding and supportive of you? That will make such a difference in giving you the strength to get better.
I am curious about the lack of sensation you describe. Have you always been that way? Does gentle non-threatening touching help you feel more?
Remember we are always hear to listen, and to provide real caring during the tough times.
Pfinstegg
Posted by deirdrehbrt on May 31, 2003, at 8:55:09
In reply to Re: DID after other diagnoses. « Pfinstegg » deirdrehbrt, posted by Pfinstegg on May 30, 2003, at 21:51:23
Pfinstegg,
You are right in that this is a lot to deal with, and I don't 'want' to deal with it. I have to though, and really have no choice.
My therapist is good and competent. She is gentle when she needs to be, and firm when that too is appropriate.
As far as sensation, the only thing that I don't usually feel is physical pain. Touch, as long as non-threatening is OK. I can feel the warmth of sunshine, the breeze on my skin, etc. I usually feel headaches although my doctor has told me that I am still up an about when most people would not be walking.
The scariest thing isn't that this happens, but rather why it happens. That's the part that I don't want to deal with. It's hard to admit that people whom you love have hurt you badly. It's hard to realize that there are parts of your life that you can't remember. Perhaps I'll be able to remember them when I am more in touch with my alters.
I'm told that being a multiple is an intelligent creative means for dealing with severe trauma. It doesn't really feel that way right now. I'm still scared, of what happened to me, and of not knowing what has happened when I find I've lost some amount of time. Either way though, it's still scary.
Thank you for your encouragement, I do appreciate it.
Dee.
Posted by Dinah on May 31, 2003, at 17:58:06
In reply to Re: DID after other diagnoses. « Pfinstegg, posted by deirdrehbrt on May 30, 2003, at 17:25:32
Losing time is something that I've never had to deal with, but I can imagine that it must be absolutely terrifying. Now that you have an accurate diagnosis they should be better able to help you with that. Are you comfortable with your therapist and his/her familiarity with dissociative disorders?
Posted by deirdrehbrt on May 31, 2003, at 20:47:21
In reply to Re: DID after other diagnoses. » deirdrehbrt, posted by Dinah on May 31, 2003, at 17:58:06
Dinah,
I am quite comfortable with my therapist, though I don't know exactly how much experience she has had with DID in particular. I know that it isn't new to her, and she has had a great deal of experience with trauma survivors. She has been in practice for over 30 years.
What is more important to me though is that she is vigilant about my avoidance. I think she's seen just about all of my avoidance arsenal (sp?). Often, I won't even know that I'm changing the subject, tossing out the odd joke, etc. Sometimes I'll dissociate, ignore the question, or what ever else it takes to not have to talk about something. I'm certain that there are times when someone else comes out and handles it for me. It helps explain how I completely forget some sessions.
The lost time isn't as scary now as it was before. At least now, I know that I wasn't asleep when I drove that last 100 miles.
It's a strange life, but knowing what kinds of things it protected me from helps. I know that those things still need to be dealt with, but now there is an adult here to help all of the kids who are keeping all of these secrets.
Dee.
Posted by kyp on June 1, 2003, at 0:25:01
In reply to Re: DID after other diagnoses., posted by deirdrehbrt on May 31, 2003, at 20:47:21
I too have been in therapy for DID. I have a great therapist. Right now I am not on any medication. I was misdiagnosed with bipolar disorder about 6 years ago. I have been in treatment for DID about a year now.
Janet
Posted by Pfinstegg on June 1, 2003, at 10:52:48
In reply to Re: DID after other diagnoses., posted by deirdrehbrt on May 31, 2003, at 20:47:21
Dee - you already sound so much calmer, and accepting of the diagnosis- and ready and able to work with your therapist. Just in these few days, you've showed us how much of you is realistic and healthy- and I can't help noticing how smart you are! All of these things should help so much in dealing with all those unruly kids!
Pfinstegg
Posted by deirdrehbrt on June 2, 2003, at 10:37:12
In reply to Re: DID after other diagnoses. » deirdrehbrt, posted by Pfinstegg on June 1, 2003, at 10:52:48
Pfinstegg
I am more accepting of things, but still quite scared; not of the dx, but of everything that stands to be stirred up in my family. I've managed to avoid dealing with them for a long time and now this isn't going to work anymore.
I also have a HUGE problem with compliments of any kind. It was a battle as to whether or not to come back here after the word 'smart' was used. That's not your fault at all, and is another one of my 'issues'. I used to play and sing at weddings... I couldn't handle people saying I did well, and I was in constant fear of 'wrecking the whole wedding' if I did badly. If I made the smallest mistake, I felt like I was stealing from the couple if they paid me.
I think that most, if not all of the people here are quite smart. I'm glad that I have now the benefit of all of that knowledge. Thank you all.
Posted by Pfinstegg on June 2, 2003, at 11:14:20
In reply to Re: DID after other diagnoses., posted by deirdrehbrt on June 2, 2003, at 10:37:12
Hi Dee.. I'm sorry I used a word that triggered so much discomfort - I wouldn't have if I had known. You are not alone in feeling that compliments come with an implicit demand that you must always function at a high level, and that failure to do this is something to be dreaded. But, if you keep posting here, as I hope you will, you'll see that some of the people you come to respect the most for their insight and intelligence do make some silly posts, especially when they are under a lot of emotional pressure- I am definitely among them!
Pfinstegg
Posted by bookgurl99 on June 9, 2003, at 15:49:10
In reply to DID diagnosis after other diagnoses., posted by deirdrehbrt on May 27, 2003, at 21:25:04
A close friend of mine discovered that she had about 20 separate personalities a couple of years ago. It kind of explained her moodiness, actually. : D
It seemed like the end of the world at the time -- she kept switching at work, and had to quit her job -- but now she's doing great on no meds at all. The meds just made her worse, side effects with no real 'effects.' Sometimes anti-psychotics are used, but this is not a case of perceiving reality differently than it is, so I don't see why they are used. This is a case of your personality literally being fragmented, and seeing it the way it is.My friend gone to regular therapy and has worked on helping the different personalities 'cooperate.' She went through a lot in the beginning, esp. when the personalities would fight with each other. In the last year everything has settled down and she's working again. It took about 3 years to get to this place.
Posted by bookgurl99 on June 18, 2003, at 0:28:27
In reply to DID diagnosis after other diagnoses., posted by deirdrehbrt on May 27, 2003, at 21:25:04
Here's a list of DID resources that were suggested to me from someone with DID:
Books:
Informational -- "The Stranger in the Mirror"
Dealing w/ DID on a day to day basis -- "Amongst Ourselves"
People's experiences (not as triggering) -- "Multiple Personality from the inside out"
Personal stories (can be triggering) -- "When Rabbit Howls" "First Person Plural"
Good website -- Sidran foundation
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