We here at the Candycan company are delighted to announce that the lovely, wonderful, marvellous, amazing T is back and we are reunited! That's my old clinical psychologist for any newbies reading (welcome!). She has been off since December and it has been, to put it mildly, fucking awful.
I don't remember the last time I felt this happy. Maybe my wedding day or when I got my GCSE results and discovered I'd got all As and A*s? OK I feel a bit pathetic now, but it's true... seeing T again has just made me feel great (and so did doing well in my GCSEs. Bear in mind that I grew up being told I was all kinds of stupid and hopeless. No one expected such things from me, never mind me.).
I was dreading seeing T again for a while as I had the attachment theories in my head and had hypothesised that given that I appear to have the disorganised attachment history and have clearly developed some kind of attachment to T, that her return would trigger some kind of adult sized strange situation re-enactment. I was half expecting myself to freeze on the spot and get stuck in a mixture of relief and despair or perhaps run up to her and grab her in my arms and then fall about crying or goodness knows what. Well, there's always next week's session but at least for this one it was just happy, happy, happy Candycan.
Although I did feel extremely nervous and my hands were shaking like a leaf during the session and now that I come to think about it... I remember thinking I was going to throw up a few times and I wondered about running out of the door. But those are just normal 'therapy' feelings for me, so I didn't really put it down to the reunion. Anyway, it was good. She is amazing. No one gets me like she does. And I'm not just saying that because I have rose tinted glasses on; the past six months without her have been all the proof I need.
Today we were just catching up a bit on what's been happening with me since she's been gone. It was kind of a whistle stop tour of the year so far and really, I only got to give her the headlines. I feel like I need to say much, much more to her. Hopefully next week we can go over some more stuff. I don't feel ready to move on yet.
Saying goodbye to New Psychologist last week was unremarkable. We didn't talk about the argument we'd had at the end of the previous session. I suppose what would the point have been? But I did notice she wasn't interrupting me and she only annoyed me once when I found out she has rang my GP for updates and to give updates three times without even mentioning it to me. I said I felt like I had a right to be told these things. I can understand why she wouldn't think I need to but that's my view. I don't have any more to say about her for now. Most of the time I didn't know whether to strangle her or award her with a medal for being a flipping genius. I am grateful for her help though; I could see she was trying and she did bring some really good things to the therapy. But, I wouldn't swap her for T. I can't handle that kind of variation in a therapist. I need someone consistent and stable and grounded, which I don't think NP was.
I've just been feeling all warm and fuzzy today since seeing T. She must think I'm a right dick, with my silly feelings for her. I told her I was really happy she's back and that I really missed her and she said she was 'glad to be back' and 'happy to see all of' her patients again. So diplomatic. Sigh. I'm really feeling like a dick myself now so I'm off to pretend I didn't just have a sudden moment of realisation that I have these stupid feelings about someone in an artificial relationship that is one sided and inevitably going to end in a painful and final separation.
And this post started so positively...
Showing posts with label New Psychologist. Show all posts
Showing posts with label New Psychologist. Show all posts
Thursday, 26 July 2012
Tuesday, 26 June 2012
Getting stuck in the toilet at therapy
Last week I dissociated badly at the end of my clinical psychology session. I had been pretty detached during the session. Not much insight and little enthusiasm for talking about myself. I think I was struggling with this part of myself who doesn't think I have DID or any history of abused and the part that wants to move forward and get everything out in the open. So I felt anxious. I must have started to come round by the end of the session because I remember asking New Psychologist what she thinks happened to me given everything she knows about me now. I remember her talking in the way psychologists do (you know, how they tend to avoid answering questions directly?) about how in time, through processing it will become more clear to me and that it is perhaps a combination of things. She talked about what some of these things were. I remember her saying she is sure my childhood was difficult, or something and I remember she used the words 'must have been awful... pretty awful'.
I started feeling like I was spinning round, like I was sitting on a tiny roundabout... or maybe I was the roundabout. I closed my eyes and tried to hold onto the chair. NP asked me what happened if I opened my eyes... I tried it and found that I could see that I was in fact, sitting still in a chair and not spinning. But then the room started to move instead. I remember the boxes behind her going left, right, left, right, left, right.... everything going left, right... fast; not slowly. Fast. It was weird. I felt tears in my eyes. I felt far away, everything muffled... the need to close my eyes was strong. The need to disappear was strong. Fighting it is hard.
I remember that I could hear her calling my name over and over. I think she was clapping in my ears and clicking her fingers... but it seemed far away, not strong enough to help. This must have gone on for a while because I remember her going out of the room and coming back to tell me someone else was waiting to come in but I was stuck. I was half there and half gone. After a while she asked if Grace could come out to help. Grace hasn't been around in a long time. I tried to ask Grace to come but I couldn't find her. Then after some time I just suddenly found myself back, like someone flicked a switch and the light went on.
I grabbed my bag and headed for the door, apologising. NP was telling me about my next appointment but I didn't want to wait around in case I dissociated again. She called after me: "Candy, can you go into the toilet because you have some black mascara on your face?" I nodded and went into the toilet to find my face looking like someone had drawn stripes on me with black paint. I cleaned myself up and stood at the sink. My breath was coming too fast. I felt... I don't know what you call it. Grief? Pain? I needed to be present but I needed to go away. I must have spent a long time in the bathroom. I remember leaning over the toilet with my fingers down my throat and not being able to vomit because I had no food in my stomach. I remember vomiting up acid and it covering my hand and it felt smooth and slimy and smelt like having the flu as a child and vomiting up bile. I remember thinking how it felt smooth like semen and maybe I was vomiting up all the badness that's been put inside me ever. I wished.
It must have been a long time because then NP was knocking on the bathroom door asking if I was OK. I croaked that I was. Then she was asking me to come out and I said I was. Then she was knocking again and saying in a loud and put out voice that I needed to come out because the toilet was for use by everyone in the department and I couldn't stay in there. I felt afraid and mortified and wondered if I could climb out the window and never come back. I knew everyone in the department would have heard that because it's small. She used my name. I don't know how I'll show my face there again.
I wiped my face and washed my hands and got myself together and headed out the door as quickly as I could. I heard her saying: "See you next week" as I rushed out but I didn't look round or answer her. I got to my car and sat with my head in my hands for a long time. By the time I was together enough to drive home it was after midday. My session had started at nine thirty so I must have been dissociated for a long time, in the session, in the bathroom or in my car.
At home I sat staring at the TV for a while but by about 2pm I was exhausted. I rang the psychology department and left a message for NP to ring me as I realised I needed to check my next appointment time with her... I also wanted to apologise. Then I got into bed and slept for four hours solid.
That was last Thursday and I guess I've been a bit of a zombie ever since. I have been dithering about what to do this week. I really don't feel like going back for more. I just want to curl up and let it all disappear and never have to think about pain or the past or New Psychologist or T again. I don't have the energy for it. I want to just not go to my session this week but I feel it is wrong to just not turn up when she has to drive to get to my appointment in T's old office. She could be helping someone else. But I don't want to have to ring her either. Either she'll encourage me to come or she'll say that is fine and I think either way I won't be happy.
I started feeling like I was spinning round, like I was sitting on a tiny roundabout... or maybe I was the roundabout. I closed my eyes and tried to hold onto the chair. NP asked me what happened if I opened my eyes... I tried it and found that I could see that I was in fact, sitting still in a chair and not spinning. But then the room started to move instead. I remember the boxes behind her going left, right, left, right, left, right.... everything going left, right... fast; not slowly. Fast. It was weird. I felt tears in my eyes. I felt far away, everything muffled... the need to close my eyes was strong. The need to disappear was strong. Fighting it is hard.
I remember that I could hear her calling my name over and over. I think she was clapping in my ears and clicking her fingers... but it seemed far away, not strong enough to help. This must have gone on for a while because I remember her going out of the room and coming back to tell me someone else was waiting to come in but I was stuck. I was half there and half gone. After a while she asked if Grace could come out to help. Grace hasn't been around in a long time. I tried to ask Grace to come but I couldn't find her. Then after some time I just suddenly found myself back, like someone flicked a switch and the light went on.
I grabbed my bag and headed for the door, apologising. NP was telling me about my next appointment but I didn't want to wait around in case I dissociated again. She called after me: "Candy, can you go into the toilet because you have some black mascara on your face?" I nodded and went into the toilet to find my face looking like someone had drawn stripes on me with black paint. I cleaned myself up and stood at the sink. My breath was coming too fast. I felt... I don't know what you call it. Grief? Pain? I needed to be present but I needed to go away. I must have spent a long time in the bathroom. I remember leaning over the toilet with my fingers down my throat and not being able to vomit because I had no food in my stomach. I remember vomiting up acid and it covering my hand and it felt smooth and slimy and smelt like having the flu as a child and vomiting up bile. I remember thinking how it felt smooth like semen and maybe I was vomiting up all the badness that's been put inside me ever. I wished.
It must have been a long time because then NP was knocking on the bathroom door asking if I was OK. I croaked that I was. Then she was asking me to come out and I said I was. Then she was knocking again and saying in a loud and put out voice that I needed to come out because the toilet was for use by everyone in the department and I couldn't stay in there. I felt afraid and mortified and wondered if I could climb out the window and never come back. I knew everyone in the department would have heard that because it's small. She used my name. I don't know how I'll show my face there again.
I wiped my face and washed my hands and got myself together and headed out the door as quickly as I could. I heard her saying: "See you next week" as I rushed out but I didn't look round or answer her. I got to my car and sat with my head in my hands for a long time. By the time I was together enough to drive home it was after midday. My session had started at nine thirty so I must have been dissociated for a long time, in the session, in the bathroom or in my car.
At home I sat staring at the TV for a while but by about 2pm I was exhausted. I rang the psychology department and left a message for NP to ring me as I realised I needed to check my next appointment time with her... I also wanted to apologise. Then I got into bed and slept for four hours solid.
That was last Thursday and I guess I've been a bit of a zombie ever since. I have been dithering about what to do this week. I really don't feel like going back for more. I just want to curl up and let it all disappear and never have to think about pain or the past or New Psychologist or T again. I don't have the energy for it. I want to just not go to my session this week but I feel it is wrong to just not turn up when she has to drive to get to my appointment in T's old office. She could be helping someone else. But I don't want to have to ring her either. Either she'll encourage me to come or she'll say that is fine and I think either way I won't be happy.
Tuesday, 12 June 2012
Dissociative struggles during a therapy session and coping strategies
While stirring the teabag in my cup today in the kitchen, I thought back to my clinical psychology session last Friday morning and wondered to myself what in the world I have been doing going to therapy for the last three years and nine months. Three years and nine months of my life attending sessions first every other week and then in recent times weekly and there is nothing wrong with me in the slightest. I thought through the phone call I planned to make to New Psychologist and what I would say: "I won't be coming to therapy this Friday, or any other, because I have been making up that there is anything wrong with me. I was never abused. I don't have alters or depression or anxiety or anything else wrong with me. I was just acting. I'm sorry for wasting time."
I realised that my psychologist would more than likely ask me if this was the 'non believing' part of my system and that she would suggest that my view may be temporary and that I keep the appointment. Then I imagined her suggesting that it's a lot of energy for someone to put into a lie for what benefit? Then I thought to myself that someone who would go to so much trouble to lie about having dissociative identity disorder should surely be in therapy anyway because clearly that is not healthy behaviour, so I dismissed the notion of making that phone call and with the intention of 'coming clean' at the next session and settled on the sofa with my tea to catch up on Big Brother.
This kind of thinking happens to me from time to time and New Psychologist has pointed out to me that it occurs clearly in relation to certain triggers. She feels that spending time with my mother is highly likely to trigger a switch to this non believing part, mainly because my mother puts a lot of energy into trying to convince me that any problems anyone in our family has are genetic and not because of anything that could have happened to us.
I believe that I am more likely to switch to this part when I am working, mainly because it's much easier for me to function if I am in denial about any of my issues. Today though, I feel the disbelief was a reaction to what happened last Friday in my therapy session. I felt strange right from the start of the session. I didn't want to talk and struggled to engage in the conversation. I don't know if something NP said eventually triggered what happened but about half way through the session I began to have strong physical sensations of something in my throat that was making me gag or cough or something. My heart was racing and my breathing went weird and I was scared, really scared. It's hard to describe. I knew where I was still but I couldn't focus on what NP was saying and I couldn't bring myself out of what was happening. I didn't understand what was happening either.
New Psychologist was helpful. I could hear her calling my name and reminding me that I was safe and that I might be having a memory of something but that it wasn't happening now. She also asked if I could look at her so that I could connect with her and know that I wasn't alone with it. I wasn't able to look at her though. She moved nearer to me and clapped her hands and called my name. I normally get really anxious when either her or T move near me but I was so involved in what was happening and scared about the feeling that it didn't matter to me that she was close. In fact it might even have helped a bit because I did feel less alone. She got me something from my bag: some smelling salts that she gave me a few weeks ago (MacKenzies Smelling Salts: they're for sinus relief actually and contain ammonia and some kind of menthol and sniffing it is like someone squirting a mixture of old style hair dye and toothpaste directly into the inside of your head. It really gives a shock. She thought they could help me if I was having flashbacks and I've been using them to help ground myself) and held them under my nose. I could smell them but even though they're strong it seemed faint and far away. I think they did help a bit though and after a while I felt my body calming and the sensations becoming less frequent. New Psychologist asked me to look around the room. She pointed out things on the walls, colours etc and then when I was more with it, asked me the date and where I was etc. Sometimes things like that really haven't helped but this time they did.
It helped that she continued to talk to me while it was happening. T (my usual psychologist) tended not to say much during times when I was having these awful episodes of dissociation and often I was screaming to her inside my head for her to help me, but not able to speak to ask. I think I'll tell New Psychologist that actually. Maybe she can pass on her wisdom of how to help to T for when she comes back.
Later in the session Little C came out to speak to New Psychologist. This is the second time she has spoken to her now. I don't know what age she is but I am guessing between three and five. She's very cute and I am lucky enough to be able to observe a lot of the time when Little C is out. She wanted to show NP a picture she had drawn and her special box of things that she had brought (it has things like stickers, postcards and pens in it). I guess Little C could feel the sensations in her throat as well because she got quite upset and told NP something about a 'thing' being 'put in there'. NP asked Little C a bit about it but LC didn't want to say too much, except that it wasn't nice. NP asked if Little C knew who it was that put it in and LC got upset and couldn't answer. She told NP she shouldn't ask that. She said that Adam does it sometimes. NP told LC that she was glad to hear her say she shouldn't ask and that it was good that she said that because... something to do with her not knowing NP well enough yet or something, and that it was OK. Then LC changed the subject and started talking about more fun things.
It's hard to write about this guys. On one hand I feel detached from it and thinking over it just makes me feel more confused about why I would have 'acted' this way. On the other hand part of me knows how real it all is and was and that is an extremely difficult thing to acknowledge. It doesn't take a genius to figure out what the sensations in my throat were a memory of when combined with the information that Little C shared about it. It's too hard to accept that something like that could have happened to me and it raises painful questions like the ones NP asked... and that's why I end up in the 'non believing' state that I was in today.
After my session on Friday I was in a lot of pain, all day. My neck, back, hips, legs and head were aching and sore. The headache lasted all weekend. Today was the first day it was mostly better and maybe that was because of the switch to not believing it anymore. Maybe it's just a way of coping sometimes. I guess there is progress in that sometimes now, when I'm in that state, I can acknowledge to myself that there are other times when I definitely know I haven't made this up and I am more content to 'sit with' the feelings and not get too dramatic about anything.
I realised that my psychologist would more than likely ask me if this was the 'non believing' part of my system and that she would suggest that my view may be temporary and that I keep the appointment. Then I imagined her suggesting that it's a lot of energy for someone to put into a lie for what benefit? Then I thought to myself that someone who would go to so much trouble to lie about having dissociative identity disorder should surely be in therapy anyway because clearly that is not healthy behaviour, so I dismissed the notion of making that phone call and with the intention of 'coming clean' at the next session and settled on the sofa with my tea to catch up on Big Brother.
This kind of thinking happens to me from time to time and New Psychologist has pointed out to me that it occurs clearly in relation to certain triggers. She feels that spending time with my mother is highly likely to trigger a switch to this non believing part, mainly because my mother puts a lot of energy into trying to convince me that any problems anyone in our family has are genetic and not because of anything that could have happened to us.
I believe that I am more likely to switch to this part when I am working, mainly because it's much easier for me to function if I am in denial about any of my issues. Today though, I feel the disbelief was a reaction to what happened last Friday in my therapy session. I felt strange right from the start of the session. I didn't want to talk and struggled to engage in the conversation. I don't know if something NP said eventually triggered what happened but about half way through the session I began to have strong physical sensations of something in my throat that was making me gag or cough or something. My heart was racing and my breathing went weird and I was scared, really scared. It's hard to describe. I knew where I was still but I couldn't focus on what NP was saying and I couldn't bring myself out of what was happening. I didn't understand what was happening either.
New Psychologist was helpful. I could hear her calling my name and reminding me that I was safe and that I might be having a memory of something but that it wasn't happening now. She also asked if I could look at her so that I could connect with her and know that I wasn't alone with it. I wasn't able to look at her though. She moved nearer to me and clapped her hands and called my name. I normally get really anxious when either her or T move near me but I was so involved in what was happening and scared about the feeling that it didn't matter to me that she was close. In fact it might even have helped a bit because I did feel less alone. She got me something from my bag: some smelling salts that she gave me a few weeks ago (MacKenzies Smelling Salts: they're for sinus relief actually and contain ammonia and some kind of menthol and sniffing it is like someone squirting a mixture of old style hair dye and toothpaste directly into the inside of your head. It really gives a shock. She thought they could help me if I was having flashbacks and I've been using them to help ground myself) and held them under my nose. I could smell them but even though they're strong it seemed faint and far away. I think they did help a bit though and after a while I felt my body calming and the sensations becoming less frequent. New Psychologist asked me to look around the room. She pointed out things on the walls, colours etc and then when I was more with it, asked me the date and where I was etc. Sometimes things like that really haven't helped but this time they did.
It helped that she continued to talk to me while it was happening. T (my usual psychologist) tended not to say much during times when I was having these awful episodes of dissociation and often I was screaming to her inside my head for her to help me, but not able to speak to ask. I think I'll tell New Psychologist that actually. Maybe she can pass on her wisdom of how to help to T for when she comes back.
Later in the session Little C came out to speak to New Psychologist. This is the second time she has spoken to her now. I don't know what age she is but I am guessing between three and five. She's very cute and I am lucky enough to be able to observe a lot of the time when Little C is out. She wanted to show NP a picture she had drawn and her special box of things that she had brought (it has things like stickers, postcards and pens in it). I guess Little C could feel the sensations in her throat as well because she got quite upset and told NP something about a 'thing' being 'put in there'. NP asked Little C a bit about it but LC didn't want to say too much, except that it wasn't nice. NP asked if Little C knew who it was that put it in and LC got upset and couldn't answer. She told NP she shouldn't ask that. She said that Adam does it sometimes. NP told LC that she was glad to hear her say she shouldn't ask and that it was good that she said that because... something to do with her not knowing NP well enough yet or something, and that it was OK. Then LC changed the subject and started talking about more fun things.
It's hard to write about this guys. On one hand I feel detached from it and thinking over it just makes me feel more confused about why I would have 'acted' this way. On the other hand part of me knows how real it all is and was and that is an extremely difficult thing to acknowledge. It doesn't take a genius to figure out what the sensations in my throat were a memory of when combined with the information that Little C shared about it. It's too hard to accept that something like that could have happened to me and it raises painful questions like the ones NP asked... and that's why I end up in the 'non believing' state that I was in today.
After my session on Friday I was in a lot of pain, all day. My neck, back, hips, legs and head were aching and sore. The headache lasted all weekend. Today was the first day it was mostly better and maybe that was because of the switch to not believing it anymore. Maybe it's just a way of coping sometimes. I guess there is progress in that sometimes now, when I'm in that state, I can acknowledge to myself that there are other times when I definitely know I haven't made this up and I am more content to 'sit with' the feelings and not get too dramatic about anything.
Tuesday, 20 March 2012
Charting stress, dissociation and fatigue to assess the links
I'm pissed off with Blogger today. Why does it think it's OK to randomly change my blog url without letting me know? And where has the fucking 'edit' button gone at the bottom of the posts so that when I've posted my ramblings I can easily go back and fix it after Blogger has decided to spontaneously delete a chunk of my writing? Love hate.
I mentioned briefly last week that New Psychologist asked me to fill in a chart of everything I was doing every hour for a week and rate on a scale of one to ten: fatigue, stress and dissociation. I think she wanted to do some kind of statistical analysis on the data to see if there's any link between the chronic fatigue syndrome and the psycho brain. I only remembered half way through the week though that she specifically said, I could edit the scale or charts but to make sure I kept the hour by hour ratings going. Oops. For the first three days I was rating the parameters by activity e.g. 1300-1530: sitting on my arse watching TV... Fatigue = 6 Stress = 3 (Home and Away can be pretty nail biting at times), Dissociation = 5 etc.
Once I'd realised that I had fucked it up I had a look through to see how difficult it would be to fix it into an hour by hour chart but it was looking like it would take someone with a fatigue of less than 'two' and I was at about a 'six' at that point so I decided it was something she could do herself if she's that bothered.
Turned out, she was bothered because she has now asked me to do the ENTIRE task again. Sigh. It's quite a consuming task and as a few of you rightly pointed out, it's sometimes very difficult to rate dissociation. I'm just doing my best though. Generally dissociation doesn't really go below a five, because I rarely feel 'real' or 'alive'. Most of the time I feel like I am an observer sitting far back on the edge of my consciousness watching a robot going about my life for me. A six would probably be once I start getting visual disturbances or floaty feelings and a seven is zoning out etc. But even then, if I'm on my own, sometimes I'll zone out without realising it and so it's impossible to rate that. There have been a few hours I haven't been able to account for.
Anyway, NP did have a look at the first weeks charts and at the session last week she proudly announced that after reviewing my charts she felt there is a strong link between stress and dissociation... get that girl a medal! Who would ever have thought that dissociation might happen when I'm stressed? OK so she's new to this maybe. I nodded and let her continue. She said it was very clear that I 'use' dissociation as an avoidance technique when I'm in stressful situations or triggers arise. I know this, but from her explanation of her views, I got the sense that she feels it's something I consciously do. I don't think to myself: "I don't like the way this man is looking at me so I might just zone out now and come back to in a few minutes". It's not conscious like that. It just happens. She says that on some level it is intentional though. I get what she means but it doesn't mean that I can stop it from happening. It just happens.
I had also decided to rate 'pain' as a parameter as I've always felt sure that the recurrant varieties of pains I get are related to stress and dissociation. NP agreed with this theory and talked about somatic symptoms which can occur with dissociative disorders. Sometimes it's easier for the body to express it's reaction to trauma than for the person to feel the emotions. She was preaching to the choir with that one, but it's good that we're singing from the same hymn sheet (huh... she must also be in the choir).
She did have some other interesting insights though: she noticed that I tend to get higher levels of dissociation as well as 'flashbacks' and intrusive thoughts around bedtime and when I'm showering/bathing. She wondered if this might be something to do with the process of undressing and being naked. It's not something I'd consciously thought about. I do struggle with showers at times. Sometimes I find myself becoming overwhelmed with anger for no apparent reason and banging my fists on the walls in the shower, which brings Adam running up to see what I need. Oops. Sometimes I've found myself curling into a ball and crying or most commonly, scrubbing my skin raw like a maniac thinking "I can't get clean! Must wash off the badness!" But bedtime... well there's the theory of getting undressed... or the whole 'bed' thing. But really I think the main reason it happens when I get into bed is because there's nothing left to distract myself with. During the day, no matter if I have the energy of a normal person or of a person with chronic fatigue syndrome, there is ALWAYS something I can do to distract myself and prevent intrusions into my consciousness. I think I just spend my whole life doing that... avoiding. Then, once I get into bed at night, it just all comes flooding back in.
I expressed this view to NP and she must have thought of that herself because she whipped out a pre-copied diagram and gave it to me to look at. It showed a flow chart of a dissociative brain which suggested that there is avoidance, where the individual (so to speak) doesn't allow consciousness of traumatic material, then there is the other extreme, where they become overwhelmed and too immersed in it and then this either leads to dissociation or switching to an alter personality. Sigh... I'll look for it and give you a better explanation. She suggested that we need to learn to be able to tolerate thinking about the difficult things without dissociating, so she wondered if perhaps we might start with thinking about something more current that causes emotions and try to talk about that. She felt this could help me 'learn' how to be present with less painful things and so I could build up a tolerance so that I might get to the stage of being able to think and talk about the really bad stuff.
Something about how she explained that freaked me out and I ended up zoning out and getting dissociated right there in the session. I think in my head, it felt like she meant that this would happen very quickly and I was scared that I'd be asked to talk about things I'm not ready to even think about. She can be quite astute. She reassured me that this was not going to happen any time soon and that she didn't expect that work would be done with her (meaning, T is still due to return after six months) and that I should be reassured that I won't be rushed into anything. It didn't mean a lot to me at the time but I have found those words comforting this week. She's not so bad. She is trying.
I sense that she's anxious about working with me. I wonder if it's the 'label' of dissociative identity disorder. Maybe she feels ill equipped to deal with the condition and so is relying heavily on text book advice and research papers. I do think that those are important, however, I can't help but think if she relaxed a bit and got to know me she'd learn a whole lot more about the condition.
To finish with a final Blogger complaint: the spell checker is not working today (either that or I haven't made any mistakes, which would be a frickin first) so I apologise for any mistakes in this.
I mentioned briefly last week that New Psychologist asked me to fill in a chart of everything I was doing every hour for a week and rate on a scale of one to ten: fatigue, stress and dissociation. I think she wanted to do some kind of statistical analysis on the data to see if there's any link between the chronic fatigue syndrome and the psycho brain. I only remembered half way through the week though that she specifically said, I could edit the scale or charts but to make sure I kept the hour by hour ratings going. Oops. For the first three days I was rating the parameters by activity e.g. 1300-1530: sitting on my arse watching TV... Fatigue = 6 Stress = 3 (Home and Away can be pretty nail biting at times), Dissociation = 5 etc.
Once I'd realised that I had fucked it up I had a look through to see how difficult it would be to fix it into an hour by hour chart but it was looking like it would take someone with a fatigue of less than 'two' and I was at about a 'six' at that point so I decided it was something she could do herself if she's that bothered.
Turned out, she was bothered because she has now asked me to do the ENTIRE task again. Sigh. It's quite a consuming task and as a few of you rightly pointed out, it's sometimes very difficult to rate dissociation. I'm just doing my best though. Generally dissociation doesn't really go below a five, because I rarely feel 'real' or 'alive'. Most of the time I feel like I am an observer sitting far back on the edge of my consciousness watching a robot going about my life for me. A six would probably be once I start getting visual disturbances or floaty feelings and a seven is zoning out etc. But even then, if I'm on my own, sometimes I'll zone out without realising it and so it's impossible to rate that. There have been a few hours I haven't been able to account for.
Anyway, NP did have a look at the first weeks charts and at the session last week she proudly announced that after reviewing my charts she felt there is a strong link between stress and dissociation... get that girl a medal! Who would ever have thought that dissociation might happen when I'm stressed? OK so she's new to this maybe. I nodded and let her continue. She said it was very clear that I 'use' dissociation as an avoidance technique when I'm in stressful situations or triggers arise. I know this, but from her explanation of her views, I got the sense that she feels it's something I consciously do. I don't think to myself: "I don't like the way this man is looking at me so I might just zone out now and come back to in a few minutes". It's not conscious like that. It just happens. She says that on some level it is intentional though. I get what she means but it doesn't mean that I can stop it from happening. It just happens.
I had also decided to rate 'pain' as a parameter as I've always felt sure that the recurrant varieties of pains I get are related to stress and dissociation. NP agreed with this theory and talked about somatic symptoms which can occur with dissociative disorders. Sometimes it's easier for the body to express it's reaction to trauma than for the person to feel the emotions. She was preaching to the choir with that one, but it's good that we're singing from the same hymn sheet (huh... she must also be in the choir).
She did have some other interesting insights though: she noticed that I tend to get higher levels of dissociation as well as 'flashbacks' and intrusive thoughts around bedtime and when I'm showering/bathing. She wondered if this might be something to do with the process of undressing and being naked. It's not something I'd consciously thought about. I do struggle with showers at times. Sometimes I find myself becoming overwhelmed with anger for no apparent reason and banging my fists on the walls in the shower, which brings Adam running up to see what I need. Oops. Sometimes I've found myself curling into a ball and crying or most commonly, scrubbing my skin raw like a maniac thinking "I can't get clean! Must wash off the badness!" But bedtime... well there's the theory of getting undressed... or the whole 'bed' thing. But really I think the main reason it happens when I get into bed is because there's nothing left to distract myself with. During the day, no matter if I have the energy of a normal person or of a person with chronic fatigue syndrome, there is ALWAYS something I can do to distract myself and prevent intrusions into my consciousness. I think I just spend my whole life doing that... avoiding. Then, once I get into bed at night, it just all comes flooding back in.
I expressed this view to NP and she must have thought of that herself because she whipped out a pre-copied diagram and gave it to me to look at. It showed a flow chart of a dissociative brain which suggested that there is avoidance, where the individual (so to speak) doesn't allow consciousness of traumatic material, then there is the other extreme, where they become overwhelmed and too immersed in it and then this either leads to dissociation or switching to an alter personality. Sigh... I'll look for it and give you a better explanation. She suggested that we need to learn to be able to tolerate thinking about the difficult things without dissociating, so she wondered if perhaps we might start with thinking about something more current that causes emotions and try to talk about that. She felt this could help me 'learn' how to be present with less painful things and so I could build up a tolerance so that I might get to the stage of being able to think and talk about the really bad stuff.
Something about how she explained that freaked me out and I ended up zoning out and getting dissociated right there in the session. I think in my head, it felt like she meant that this would happen very quickly and I was scared that I'd be asked to talk about things I'm not ready to even think about. She can be quite astute. She reassured me that this was not going to happen any time soon and that she didn't expect that work would be done with her (meaning, T is still due to return after six months) and that I should be reassured that I won't be rushed into anything. It didn't mean a lot to me at the time but I have found those words comforting this week. She's not so bad. She is trying.
I sense that she's anxious about working with me. I wonder if it's the 'label' of dissociative identity disorder. Maybe she feels ill equipped to deal with the condition and so is relying heavily on text book advice and research papers. I do think that those are important, however, I can't help but think if she relaxed a bit and got to know me she'd learn a whole lot more about the condition.
To finish with a final Blogger complaint: the spell checker is not working today (either that or I haven't made any mistakes, which would be a frickin first) so I apologise for any mistakes in this.
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