Are there different degrees of switching in dissociative identity disorder?

In response to a very heartening comment on an old post asking if I had given up on blogging, I had said that I would answer that question with a post. I have felt bad about that as it was quite some time ago and I never did post again, but I feel now is the time to admit that it has not been for lack of trying. I did try to write a post to get me back into it but it somehow became a monumentally long autobiography and by the time I reached the age of sixteen in the post I was feeling utterly exhausted and overwhelmed and also realised that no one in their right mind would want to reach something so long, so I never posted it. So instead of trying to write a 'getting back into blogging' post, I have just written a post. A plain old standard post with no mention of my lack of blogging, no introductions for new readers and no apologies for not blogging etc (aside from what I have just said). So here you go... (oh and PS, I'm doing a lot better lately than I was a year ago and maybe I'll tell you about that some other day)

In therapy this week my clinical psychologist and I discussed the previous session and some 'switching' (changing from one part/alter/personality being in control, to another) which had occurred during the session. My memory of this is vague... I remember being anxious, not being able to breathe, then feeling like... bad feelings in my throat... then I don't remember what happened next... then I was watching someone talking to T (I was watching from inside my body, in the background, far away) and asking her what she wanted them to do for her. I could see out. I could see the room and I could see T and hear her saying I wasn't anywhere but her office but it somehow didn't make sense and I wasn't the one talking to her. I remember everything being blurry and later my eyes feeling strange and not being able to see properly.

This week, on meandering through our reflections of the process from each perspective together we talked about degrees of switching. Or perhaps we came to conclude that there are degrees of switching. The switching that happened last week was clearly obvious. It was clear to T that I wasn't the one talking to her. I don't have much to say about that really. That's an obvious aspect of DID. But for me there is a different kind of switching, which seems to be more of a grey area.

I can't remember exactly how this came about but at one point I commented that sometimes I don't know 'who' (or which part) I am. I feel like I am actually a different person (not just observing a different person) but I can't say who and I feel that other people probably wouldn't even notice but to me, I am someone else. I happened to be feeling this on this particular day also, I don't know if that's part of why I was talking about it or not as it happens at other times and I don't mention it. I had noticed the change about an hour before I went to my session but I didn't mention it to T because I didn't feel it was necessary; it seemed like more of an internal difference than an out and out switch. I was taken aback therefore when T responded by asking if I felt that way at the moment because she didn't think she was talking to Candy. This surprised me a lot as I hadn't actually realised how obvious my 'internal changes' are.

I couldn't help but smile a little at that moment. I think it was relief actually because I want to be 'seen' and understood and T had just proved that she does see me and notices these subtle changes... or I am more obviously different than I thought. But either way I just felt glad that she seemed to notice and understand. Even Adam doesn't get it sometimes. He knows how to identify some of the parts and responds to them accordingly but there are times where I think he just assumes I am in a mood or something. Don't misunderstand, one alter can have moods. I can be in a bad mood and it not be that I have changed to a different part. I may be a part but I have more than one aspect to me nonetheless.

So T had realised she wasn't talking to 'Candy' and wondered what part she was talking to. I explained that I still feel like I am Candy but that I'm also someone else. It's hard even for me to understand that; let me try to explain... When I completely switch, I often feel like I am observing someone else from the background. I am Candy, but I'm not out at that moment so I am not the person you will be talking to; someone else is in control of me and I am just seeing out from the background. However, during these less obvious switches I still feel I am the person in control and I am talking to you but I am actually someone else, rather that just observing someone else. Does that make sense? Yeah, I'm not sure either. If you have DID you are probably kinda getting it and might have better words or knowledge of dissociation to explain it.

We discussed a little bit and T proposed that it is like I am in between the two; the two being 'myself' and 'another part'. She said: "You're neither here nor there" which I found kind of funny but true in a way. On this day I seemed to be in between being myself and being Ebony, a darker part. T said that I seemed like a less happy person, more subdued. (I wondered then if she ever does sees a 'happy' side of me? I often feel she only sees the downer sides of my personality and then I worry that she must find me a terrible sad sack and a bore) So could it be that it's half a switch? Or is it that I have switched to another part but that me and that particular part are not entirely separate personalities?

In general we like to think of Dissociative Identity Disorder as involving very distinct, separate personalities who have no shared knowledge or memory with the other personalities. I suppose that is what is even 'required' by those who make a diagnosis of DID. In reality, for me anyway, it is not all clear cut. I can't deny that there are those levels of separation (I try to deny it plenty but that's another blog post) but there are other levels of separation which are not so distinct and separate. Is this what it's like for people with Borderline Personality Disorder and Complex PTSD? This reminds me of when I used to try to figure out what was wrong with me when I knew I had dissociation but wasn't sure what diagnosis I would have. It's hard to really worry about categories or symptoms and diagnoses anymore. I used to worry about what my official diagnosis would be if I was 'tested' etc, like it made a difference to how I should feel. I guess I thought if I got diagnosed with DID it was more serious than if I got diagnosed with something else and on one hand I didn't want that because I wanted to be able to deny anything bad could have caused it, but on the other hand I felt if I was told I didn't have DID then I shouldn't be feeling the way I was and that, somehow would make me feel bad.

Nowadays I don't worry about it so much. I have learnt somewhat to accept the periods of denial I go through and not get tangled up in analysing myself but try to sit with the feelings and remember that sometimes I feel differently. Then during the other times, when it is apparent that I very much do have a dissociative disorder and I am more aware of intrusive images and symptoms etc and starting to feel overwhelmed by the need to either accept or deny that I was abused in this way and that way and the other way by him and her and him and them etc... then I try to keep it simple by forgetting about the past and focus on looking at how my life is affected at this moment in time and remembering that this is what I am working to change in therapy, no matter what has caused it. Phew. Hard to write parts of that last sentence and now I am having to do the very thing I just wrote about. It's upsetting and it's an ongoing thing that affects me. I don't need to analyse it more than that at the moment. Breathe...

I digressed a bit there, sorry. To get back on point... maybe the levels of segregation/separation in a system (all the parts/alters/personalities that make up one human with DID) can vary as well from one time to the next. On one day I might be able to be more aware and involved in being a different part where on another day I might be more oblivious to them. I think the experience of feeling like I am another person is a good thing though. It allows me to be able to be more connected to my  DID 'system' and even if only for a short time, realise that therapy is the place for me and that I am not a total time waster who's lying to myself as well as my therapist.

I didn't feel alone

I'm still enjoying having T back: my old psychologist who was off for just over half a year. She has been so supportive and understanding since she returned. Well, she always was but the contrast between the way I felt with her stand in (New Psychologist) and T's style has just made me so much more aware of and grateful for T's ways. I feel like I am properly starting to trust her on a new level. It may still be fragile but it's more real now. It's like her time away and return has strengthened our relationship somehow.

From a young age I started to believe that people won't care: humans can't be trusted; they will hurt you and leave you. T did leave and although she said she was coming back some parts didn't believe she would and it hurt so much. But, T has come back like she said she would and she has cared for me and it seems to have been a huge thing internally. It's been somewhat 'healing' in a way (I don't like using that word but have to admit that it is the right one in this circumstance). It has helped to begin to challenge my beliefs and now parts are starting to believe that maybe you can rely on other people to help. Maybe humans can be trusted sometimes.

Since she came back we have done a bit of catching up. She was very good about my rants about new psychologist and some of my more negative experiences I had in the early months of the year, which I needed to get off my chest when T came back. If you've read some of my posts from during that time you'll know the gist of what I was ranting about. She's very skilled at being supportive without taking sides but I imagine that secretly she did agree with my concerns some of the time.

T has now also met Little C a couple of times. I guess this is a pretty big thing as LC and a lot of us have wanted T to be able to talk to more parts for a long time but couldn't get past the barriers of fear and trusting that it would be OK. I'm not sure how I feel about it since it has happened. I mean, I know it's a good thing and in one way I'm happy but it's also something that I feel a lot of ambivalence about. But maybe that's for another post. I know it's progress, whether my feelings about it are always good or not.

I rang her recently whilst in the middle of a 'crisis' for support and she talked to me on the phone for ages. She was so supportive. I can't remember most of anything that I said to her: I was having a meltdown due to being in a very difficult situation with a lot of triggers. I remember that she talked me through how I was feeling and reassured me that it wasn't going to last forever. She said that it was a good thing that I was feeling emotions and she understood that it was so difficult because I've not had much experience of really 'feeling' emotions before. Dissociative disorders are all about not having to be aware of or experience painful feelings, so where in the past I have often been able to block things out by dissociation, it is progress that I found myself experiencing these feelings, although obviously it didn't feel like a good thing at the time.

I remember she said she wanted to reassure me that I hadn't done anything inappropriate in contacting her. I wondered afterwards if she had said that because of the situation where the stand in psychologist had told me off for contacting her between sessions saying it was inappropriate and a boundary issue. I wondered if T was trying to reassure me because of what had happened. Well, whether that was in her mind or not, it was important for me to hear that because I did worry that I shouldn't have been contacting her. I always fear being rebuked for it. I suppose that's nothing new. I am rebuked internally by someone every time I reach out too. I take a step in trusting and talking to her and then that person rages up with anger and fear, shouting at me curses for breaking the rules and prophecies imminent devastating consequences for us all because of my actions.

She said a few things that really impacted on me and stayed in my mind for a long time after we'd talked. While we were talking on the phone, someone who has caused me a lot of pain was walking towards me. I told her that this was happening and her response was that she was still here talking to me and she wasn't going anywhere. It doesn't sound like a big statement but she could not have said anything more perfect or reassuring to me at that moment.

Some of the time she didn't say anything and I didn't say anything. She just sat with me on the other end of the line while I 'felt' and while I dealt with how I was feeling and started to calm down. She told me she wasn't going to hang up the phone until I felt OK and that she was here for as long as I needed to talk to her. I didn't feel alone. I didn't feel alone. That was the amazing and wonderful new experience in the middle of this crisis: I didn't feel alone.

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.

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.

How suicidal do you need to be before you talk to someone about it?

I wrote this post on Friday afternoon but got distracted before I finished it. A lot has happened since I wrote it but I'll post this first and hope for some blog time again before too long.

Friday 23rd December
It's hard to believe it's Christmas! I mean that because I have been dissociating a lot over the last weeks... in the way where the world and I seem unreal and unconnected. Derealisation? You'd think by now I'd have the hang of the different types of dissociation and what they mean but it's still unclear. I kinda have my own words for things. I can see the tree and the presents and hear the music but I can't connect with it somehow. I normally love Christmas and get so excited but this year I feel like I am just going through the motions.

I have had a lot on my plate I suppose, what with work stress and T's imminent departure and the prospect of the new year and what it will bring: a new job, a new psychologist and probably a new schedule of hospital appointments for my blood disorder :( I'm not looking forward to any of these things. I'm not relishing the thought of being another year older either. When I first started psychology I felt like I was only just an adult. I felt young. Now I feel old. I'm not old, but I'm aware how quickly time has passed me by over the last ten years and I worry that before I know it I will be old and I will feel like all I've managed to do is struggle through life and with what goal? What actually is my purpose for going to work? It's to pay the mortgage and bills and be able to eat. But why? If my life is taken over by work, what's the point in prolonging it? The only point really is the hope that change will come. Maybe one day I won't be in a job that leaves me with no capacity for a life. There are times when I envy the people who are on DLA (Disability Living Allowance). God knows I'm sure I could qualify for it if I decided to try. Sometimes I think the only thing that stops me is that I have a mortgage to pay so I must go to work. Sometimes I'm not sure what keeps me going but I feel sure that whatever the reason is, it isn't going to keep me going forever.

I'm eventually going to have to face the fact that I don't know what I believe about God and Jesus anymore. I'm going to have to try to come to some sort of agreement within myself about what mybeliefs are in terms of if there is a heaven and hell and what I need to do in order to make sure I don't go to hell if so. It sounds like a stupid concern for people who don't believe, I'm sure. For me it is so huge that I avoid thinking about it because I know I am not going to find definite answers and if I do, the answers are not likely to be the ones I want. This is all very vague, I know. I guess I don't really want to get into it just now. But going through life avoiding it isn't doing me any favours because it's still going on inside. There is still that voice reminding me that I am going to burn in Hell for eternity if I don't get myself sorted out.

I mentioned before that T and I talked about suicide last week. It seemed to be the theme again this week. I find it hard to talk about. T was surprised because I mentioned that last year I had written a suicide letter and she wanted to know a lot about it: why I wrote it, what was in it, had I intended to use it, what stopped me from ending my life etc. Hard questions. I had mentioned it because my thoughts had been centred a lot around suicide recently and I said I was concerned that after she goes things might get a lot worse. She was trying to assess the risk. She wants me to promise that I would ask for help if I felt I needed protected from myself. My problem with that is that I don't know at what stage I should ask for help. If I tell someone when the thoughts are in my head and I'm planning out what way I would do it, without actually having decided for sure that I am going to, I'm just going to cause unneeded stress and upheaval and interventions that might not be necessary if the feelings pass. But if I wait until I have made the decision, I'm not likely to want to tell anyone am I? If you decided suicide was the right choice, why would you then want to tell someone when you know they would just stop you? I felt T didn't really get what I was saying. She kept telling me that I would know when things had got to a stage where I needed to tell someone. I hope she is right.

She also said something which hadn't occured to me before: she said that when people tell her things like I did (ie that they wrote a suicide note last year because things were so bad) she is concerned that they didn't share that at the time, despite coming along to sessions. She said it puts pressure on the therapist because they can't trust that the client will inform them if things are really bad in future. She said it can become an issue that is always hanging over the sessions and affects the therapist's confidence in whether the patient is going to be able to cope with things that may be covered in the sessions. They may then be wondering if delving into certain issues is going to put too much pressure on the client or if it is the right time because they wouldn't know what the client is feeling at that time.

I felt guilty and sad when she said this. I don't want to hold my therapy back in any way and I don't want people to worry about me. I'm desperate to feel progress. So I think I will need to agree the suggested contract that while in therapy I am to tell someone if I feel this way. But something holds me back. I don't like to break my word and if I agree a contract, I need to know I can stick to it and in all honesty, how can I promise that? And how can I speak on behalf of others? And we are never going to get agreement from all of the parts.

T ended the session quite abruptly then and I found myself struggling. It may be normal for her to talk about these things with people every day but for me, it had stirred up a lot of pain and I was feeling myself dissociating in a physical way (my head feels weird, my vision goes weird, my hearing and all my senses go weird... not a great explanation but hard to explain). I felt sure she just wanted to get away promptly, it being her last day at work before Christmas. I didn't feel OK to leave, I felt really bad. I was struggling but I got myself out the door and to my car where I sat with my head buried in my scarf in my hands for probably a long time before I felt present enough to drive home. By the time I left the car park T's car was gone so she must have come out while I was sitting there. I wondered if she saw me and just decided not to see if I was OK because she wanted to get home. I felt hurt when I thought that could be the case. That was Thursday evening.

Questions for my therapist

I had a session at psychology today which for my standards went very well. I was nervous about going in function mode but T has been really good about it. She kept things at a tolerable level and didn't try to talk about 'parts' too much. Instead we chatted about function mode itself and why it happens. I also got to ask some more of the questions that I've been wanting to ask for a while. I had gathered a list of questions which I never really get a chance to ask and last week I suggested that I would like to ask them. It has been a good time to do this because it gives a focus to the sessions where we are taking a step back temporarily from the more intense work we have been doing while I am in function mode.

Last week I asked about the plans for T's leaving as she hasn't talked much about it (I'll tell you about this some other time).

This week I asked about EMDR. T had talked about doing EMDR with me a long time ago and had actually tried it out briefly but I had become really anxious at the time and she didn't mention it again afterwards. I've been unsure as to whether it is going to happen or not so I asked about that today. T told me that it is still on the cards but would be later down the road as there is work that needs to be done with 'parts' before it can happen.

I also asked about my first ever appointment at clinical psychology. You may remember that I had looked at the Dissociative Disorders Interview Schedule recently and recognised that the psychologist I originally saw had asked me questions from it at my first appointment. I was curious as to why I was asked these questions as my referral was for 'depression'. I wanted to know if the psychologist just routinely asks these questions or if something I said even back then made him suspicious that I had DID.

T was not sure; she said that the psychologist I saw then worked a lot in the field of trauma so may have noticed something. She looked back at my notes from that day and read out that my first description of myself and my problems included that I had suffered depression on and off throughout my life and that I had memory problems which had been getting worse in recent years. I'd also said I didn't feel normal and felt different from other people. She said that the memory problems could have triggered him to ask me about dissociation.

It means a lot to me to think that my dissociative disorder may have been evident to the psychologist even back then at the start. I know it's silly, but even after all this time I still occasionally have periods of doubt about if I have DID. Sometimes I am just so separate from my memories of childhood that it seems impossible to believe that anything traumatic could have happened to me. Sometimes I just feel fine and like one single person and I think I must have been making up stories.

It's reassuring to find evidence to suggest I may not have made it all up after all. It may be hard to understand how a person could think they have made something like that up if they haven't, but DID in itself means a person can have so many different states of being that it is entirely possible that one alter could be so separate from the others that to them they are the only one. At those times, when I reflect that I have been going to therapy for four years I marvel at this fact and wonder what on earth I have been doing wasting valuable NHS time when there's absolutely nothing wrong with me. At those times I am blind to the others. I don't realise that they are not far away. It doesn't take much to bring back the part that sees life differently. I forget that not too many weeks ago I was passing the time by tying ropes around my neck and thinking about how appealing the bannisters looked.

Alters taking over during therapy sessions

This is the second half of the last post so you may have read it before. I decided to split it up into more bitesized chunks!

Recently in therapy, my psychologist and I ('I' being the part that attends therapy most of the time) have been talking a lot about the issue of switching in therapy and parts talking to her. For the most part, T's communication with my alters has been via me telling her what they think or are saying from the level two section. Quite often she will ask what the parts think about this or that, or if any parts have any views on x or y. Normally then I will go quite for a bit while I listen to what parts inside may or may not be saying and will then express these views to her. 

This works well in theory but has two limitations: one, is that I tend not so much to narrate but to edit what others are saying to make it fit in with my expectations as to what T will be OK with hearing; sometimes I might ignore a view completely if I don't feel the expression of that view is something I have the confidence to put out. The second problem is that it's not always straight forward. I can't always hear everyone well and make sense of things. There may be so many people are speaking at once that I can't make sense of it at all. Or, there can be a sort of whirlwind that starts up in my head and then I get overwhelmed and feel completely clueless altogether (this may be a way of parts protecting themselves from me being able to give away their secrets: I'm not sure). Sometimes, the parts are all at level three and I don't have a hope of being able to know what they think. So this way of communicating has it's drawbacks.

I think T and I both agree that if some of the parts were able to speak to her themselves it would be useful for them and for 'us' as a system (group of alters). Now, this has happened at times. I know that some of my alters have come out to speak with T in the sessions. Most times it has happened, I have been aware of what was happening. There may have been times I'm not aware about, I like to think not, but then maybe that's naïvety again. Most of the time, when my alters want to get out to speak to her during therapy it isn't just a simple switch because of the main person who attends the sessions. This is because it can be difficult to give up control and let others out, mainly because I am afraid of what will happen if I am not in control i.e. what will they say or do and how would T react to that? This can result in a huge struggle of parts against me (or the person who attends the sessions) which can lead to a static state of anxiety and dissociation which doesn't result in anyone getting the floor. 

 

Some of my alters have also communicated with T in the form of letters or pictures. This has been useful in a way, but not enough for them. I know they all feel they have a right to be at the sessions and meet T and speak with her themselves and I agree, they do deserve that. It frustrates me that I haven't been able to let them speak to T more often because it would make my time at therapy sessions a hell of a lot easier if I didn't need to be the one talking all of the time! My alters get angry with me for not being able to let them out. I get angry with myself! But at the end of the day, it has been an instinct my entire life to protect myself from hurt by hiding things from others and even myself. I spend my life keeping alters in in order to maintain normality and sanity and it's hard just to go the opposite way, against my instincts. The other thing is, if I do let alters out and something goes wrong (we get hurt in some way), it will be me who gets the blame for this. So you may understand the apprehensions.

The issue came up again a couple of sessions ago as a result of the letter I sent to T. The discussions headed along the lines of 'what can be done to help us get unstuck and allow others to feel safe to speak and me to feel safe to let them speak?'. This has been a frustrating question for me as I truly don't know the answer, or have any ideas of possible suggestions! I have felt it is something I can't get by. After expressing my 'stuckness' and discussing things more, T told me that she wanted me to leave the issue with her as she could see it was a big burden on me at the moment. When T said this, I had one of those moments in life where I truly felt cared for and understood. I felt such a relief that I could have leapt up and hugged her at that moment. Sometimes it can be frustrating when therapists don't feel they are there to provide any kind of suggestions or ideas in the way of practical help. I have sensed that the idea is for me to come up with the answers myself. This has always angered me a bit. I'm not a stupid person (on average) and if I had the ideas of how to get better in myself, I would have been trying them out before now! So T giving me a real answer to a problem (if only that she would hold on to the issue and think about what could help over the next few weeks) is like another breath of fresh air. She has given me a few of those lately.

Part of me says she won't come up with any answers, but partly I doubt that negativity. T has surprised me more and more with her ability to find answers to seemingly impossible situations. And even if she doesn't come up with anything, it has been such a relief to not have to think about the issue and try to solve it on my own over the last week or two. She has given me other homework though, which I will tell you about some other time. So for now, the issue of how I will be able to let parts out when they want to speak is just 'sitting'...but not with me.

Dissociating by getting stuck: is it under my control?... and what happened next...

Alright, enough procrastination! I will now tell you what happened in the clinical psychology session of last week. Ironically... (or is it ironic? My husband gets on his high horse about people using the term 'ironic' when the situation isn't actually ironic, which makes me nervous about using the word incorrectly and being scoffed at by all the intelligent people in the world... anyway, ironically or not....) this ending of the procrastination is in itself a way of procrastinating from some study I should be doing for work. Best to do this though before this week's psychology session.

Just to give you a recap in brief of what had been happening previous to the session to set the scene... I'd had a difficult few weeks because of:

1. becoming aware of an apparent wish of some part of me to be dead (the 'becoming aware' part involving me being an observer of the act of preparing for a hanging on numerous occasions)
2. Some general internal chaos and a feeling of 'me' being dragged along behind while the other alters were on some kind of mission to break free.
3. having dissociated badly in the previous psychology session (which I talked about here) and feeling generally crap as a result of that
4. My T emailing me to see how I was after the dissociating badly in the session and then failing to respond to me at all when I told her I was not good; on the edge and really scared because of my thoughts and actions, hence leaving me feeling angry with myself for having thought she cared and trusting someone against other parts' better judgements and also leaving me no better off in the current crisis that I was in (which I also wrote about in this post).
5. work being really, really, really stressful (that has now eased off a bit, thank goodness)

So, I went along to therapy last week with all my parts in tow and all of these things hanging over my head. I always look forward to going to therapy but once I get there become really scared and anxious as my alters stir up inside and because of the potential threat of what terrible thing T could do to me or make me talk about. Sometimes she has an agenda for the session, sometimes she asks me what I want to talk about. I usually prefer it when she has an agenda as it takes the pressure off me a lot, but this week I did not like her agenda. 

She started off by stating, in a manner that seemed to me to be quite short, that the last session had run very late over time (because of me being stuck to my chair) and that we needed to sort out the 'dilemma'. She said that it's stressful for her and unfair on the caretaker who was waiting to close up the building. She said we could consider moving the time of the sessions to a different time of day but that it doesn't negate the fact that over two hours is much too long for a session (it should be an hour and a half) and that if she saw me earlier she'd probably see other patients afterwards and that she 'certainly wouldn't keep them waiting'. She said that she understands that it's a struggle for me when I am in that state but that it is in my control on some level because it is another part that's stopping me from leaving.

Now, these are all fair points and she had a right to raise the issue. But it seemed to me by her tone that she was quite annoyed with me and that despite acknowledging that it is another part that is causing the difficulty, that she feels maybe I could just try a bit harder if I really wanted to not be a nuisance. As a result, I instantly went into 'defensive mode'. If I am accused or confronted in a negative way I have an immediate reaction of a sort of closing off. It's like we are all living in a fortress. I try to keep the doors open and one or two people hanging around outside, but at any sign of attack, everyone runs inside, the doors go up, some parts go into hiding while others take up position in their stations ready to defend. I think she picked up on this pretty quickly as I went silent and probably didn't look too happy. My heart was hammering in my chest, my vision blurred, my head spinning. Someone inside was saying: “Lift your bag and make a run for it!”

T was repeating the aforementioned points and saying she hoped we could discuss it together and I was hearing: “I hate you! You are a horrible patient! You are trying to manipulate me by staying longer in the sessions. You are selfish and just want more time and you can't have it because I only get paid to see you for x amount of time. I don't care about you any more than that. In fact, there's probably not even anything wrong with you, you're just looking for attention!” Of course, that is not what she said. That is just me being over-sensitive. 

 

My silence continued. She asked how my parts were feeling about her having raised the issue. I told her I felt she was angry with me and she agreed that she got the sense that I thought she was and that I was annoyed in return. Well observed T (I probably had it written all over my face though)! She told me to stick to the facts of the case so I told her, that the fact was that she seemed annoyed. She didn't say she wasn't but she wanted to know what it would mean to me if she was angry (typical psychologist!).

Well, I don't plan to dictate to you my entire memories of the conversation (I'm sure you will be relieved to know) but it kind of went on that way. Me in silence, feeling like I was going to die off and seething with anger that she thought it was in my control to be able to get up and leave during those horrible episodes of whatever is going on and her going over the same statements about how she wanted to understand why some part of me doesn't want to leave the sessions and what I thought could be done to fix this problem. 

 

Her statements pissed me off for a number of reasons: one, is that they assume that some part of me doesn't want to leave and that I as the 'host' or whatever, would know if and why this was the case and also what would change it. Secondly, I felt angry that it was me who was being 'told off' when it's not 'me' who is causing me to be in that state. During those times, I feel so separate from myself. I am like an outsider, willing the other parts to let me back in or get up and leave. I was angry with her for holding 'me' responsible and angry with the rest of me for getting me in trouble when I spend my whole fucking life trying to be 'good' and 'normal' and blend in despite being full of a whole rainbow of nutters who are all bursting to get out and live in a way which would be conducive to losing my job and any relationships I currently could claim to have a feeble grasp on. 

 

I wasn't so much aware of the next reason for my anger at the time, but on reflection I know that am angry about it: I had been feeling like my alters were moving forward without me. They were learning or I was learning to let them be independent of me in communicating with T. The perceived attack of last session sent them scampering away back into hiding. Then she wanted to hear what their thoughts and feelings about the issue were. By this stage they were so far away, there was no chance of anyone communicating with them. I think Little C had already had her confidence knocked a few weeks before and given that I think it could be a part that is in great distress who has been trying to communicate with C during times that I am dissociating, they then felt castigated for having caused so much trouble. I feel this could be a big setback in the already possibly hopeless task of trying to learn to trust that people aren't going to hurt us.

T continued to want me to talk about the issue throughout the session. I don't think she could really understand how impossible it was going to be for me to be able to have the insight or let my guard down enough to talk sensibly about it. I tried going out to the toilet to pull myself together but it didn't help: every time she tried to raise the issue again I felt my heart rate rising and my vision going again. I kept trying to explain how I was feeling and she kept saying: “does that mean we can't have a conversation about it?” So frustrating!

On reflection in the time since the last session, I have been asking myself the question: “Did I have justification to believe she was quite short in her tone and manner of raising the issue or did I just perceive it to be that way?” In honesty, I really don't know. Maybe she was nervous about raising it with me in case I did react badly and this came across to me as blunt. Maybe it was just my wrong perceptions and that's all. It is important to me that she is not angry, because if she is, it suggests she really doesn't understand how out of my own control the problem is. 

 

I didn't want to leave the issue hanging without any attempt at trying to fix things though, so I sat down and wrote T a letter explaining what was going on for me when she confronted me in that way and then, what I felt we could try to do to help prevent the sessions from running over time in future. I also told her how I had felt about her lack of response to my email a few weeks back. I felt my suggestions for what could help were feeble (because if I had better ones wouldn't I already be trying to use them?). I still feel angry too. I guess I also feel, she should be the one with the answers. Surely I'm not the only person in therapy who experiences dissociation? Well, if there are others then can't she find out from some source what can be done to help? I sent her the letter by email anyway, although part of me feels she cares so little that she probably won't even bother reading it. Another part says, who gives a fuck if she doesn't. She raised the issue so if she doesn't read it, it's her loss. 

 

I have been feeling numb for the main part since the session. In the glimmers of emotion I have had over the last week or two I have noted 'fear' about going the next session which will be on Wednesday. I know that my anger is still not far from the surface and I also feel the part that thinks 'to fuck with therapy' is not far away either. I have also sensed feelings of 'loss' and a disappointing feeling of reconfirmation that no one could ever see anything good in a person like me and that I should have never hoped for anything different. I haven't seen the kids around much as I mentioned here, but I have a sense that they are feeling pretty bad for getting in trouble. Pan might be angry, but that's just a guess as I haven't seen him. I think they are hiding.

One kind of dissociation: getting stuck

Last week you may remember me telling you that my clinical psychology session didn't go well, but I didn't go into it. I will write about it but first, here is something I wrote a few weeks ago after the previous psychology session. It will set the background for when I tell you about what happened last week...

"Last week I had a tough session at clinical psychology. I did talk about some of it (the discussion about the rope... cringe) on a blog post a day or two afterwards but I haven't reflected on the other parts that made it tough.

I was dissociating during the session again.This for me can involve a sort of shutting down of my ability to do anything. It tends to happen if I get overwhelmed which is always a possibility being in a psychology session. Just the silence is enough to send my insiders into a whirlwind.

It doesn't happen as much at home and I think that's because at home, I am not so likely to feel highly anxious and if something triggering was to happen, I would allow the process of dissociation just to happen for instance: by zoning out or falling asleep suddenly, or just curling up in a ball and shutting down. At home I might also find some way of dealing with the overwhelming emotions, such as hurting myself, which would prevent the emotions from becoming too much.

In a psychology session, none of these coping mechanisms I use at home can be allowed to happen. I am required to stay 'in the room'. I can't just shut down and I wouldn't want to either in front of someone else. It's not safe. Obviously, self harm isn't an option either. Another obvious thing though, is that freezing up and becoming glued to my chair isn't the safest option either. It's like part of me is trying to get me to shut down and another part wants me to get up and run away and both are pulling in opposite directions, so I end up 'stuck' in the middle unable to do anything.

I know that in the past it has been very specific things that have caused the dissociation to happen. Last week though, I felt it was separate from anything I was really aware of. It felt more like a physical process that began of its own accord and was not related directly to how I was feeling. I have no doubt however, that it was related to some other part of me that was feeling overwhelmed in some way by something frightening.

I can feel the fear in my body even if I don't know what it is that's causing it.

Apart from the obvious horribleness of the experience, it can also cause the session to run over time. I am then trying to pull myself together in order to just stand up and walk out to my car but failing to be able to do so. My head is telling my body to get up but my body isn't co-operating. I hear T telling me that we need to leave the building because it's closing (I always see her last thing in the day) but she is far away from me. Or I am far away from the person she is talking to. I am conscious of everything happening in my body and I can hear her, but I'm not in control of my body. I'm not connected enough to be able to move.

I don't know all that the part that is overwhelmed is thinking or what it is they are battling, but I do get a strong sense of fear. I feel it in my body. I sometimes feel other things in my body too at these times.

To add to the horribleness of the situation, I tend to get a really irrational fear that if I don't snap out of it T is going to get fed up (or more fed up) and leave me in the building by myself to get locked in. Sometimes she gets up to get her things together while I am in my frozen state and I feel a panic rising in me that I am going to be left like this on my own. Logically telling you this now, I know she wouldn't do that but in those times it's a different logic. There is someone inside at those times begging (unspoken) for her not to leave them alone there. I (or some part of me) also get scared that she is going to hurt me/them in these times. I fear she will get angry and start shouting at me or physically hurt me. A few times she has gone behind me to shut the window and that part has been waiting in that moment for something terrible to happen from behind the chair, but still... unable to get up and run away. It's a kind of chaos.

And that's just my experience of those times. It's one dimensional, I am just one part of the several people who attend the sessions and I'm sure others are thinking and feeling differently at that time. Sometimes I feel like the only measure I have of what is going on in someone else at those times is what I can feel in my body. It's in those times that I hear a doubting part voicing their confusion; because if I don't have DID, then why are these things happening to my body? Sometimes I can feel the emotions too. Fear, as I mentioned, is a big one.

Related posts:
Dissociating by falling asleep

From other blogs:
Dissociation, Freezing, and Falling Asleep
A recent post by Astridetal, which links in with this one. Astridetal talks about her experiences of this type of dissociation.

Losing time

I wonder if I lose more time that I tend to realise. Lately I seem to be incapable of remembering to drink my tea before it goes cold. Ad is very good at making me tea; he's also become very good at reminding me that he's made me tea when it's sitting right next to me. Another thing I've noticed in recent months is that I am also almost incapable of making toast without burning it. The only way for success is to stand over it staring at the bread. If I try to multitask, without fail I will end up nearly setting fire to the house. Is it because I am dissociating and time is jumping on or am I just a fluff head?

Nice ta meet ua

I need some list of emotions to be able to pick the ones. I don't know who I am. Nice to meet you anyway. I think my brain got put through the shredder. It didn't go well with the T at fucking clinical fucking psychology. Some think we shouldn't go back. We probably will though cos she's pathetic that way. I've got a fucking rib sticking out the side of my fucking rib cage. It sticks into the mattress. That's nice isn't it. Even nicer when I heard it snapping. I wake up in fucking agony cos I been lying on it and I can't move cos it's bent down and if I lift up it feels even sore. Why peple always want to sit on you and squash you like a slug. Fucking wankers. WHo the fuck think she is? Friday coms I want to slash our arms open but she wont fucking let me do it if she can help it. Doesnt help though anyway you jsut get interrofgations aftera and wish the world could eat you up. We are not not worthy. I got as much right as you to be here so shut your gob. Not you Mr and mrs blog reader, I just telling them others inside to ficking piiss off and give me a chane to have my say/ Sorry i cant spell, shes trying to fic x it as I go cos otheriwsise you wont be able to read any of it. its waoudl lohk like this if she doesnt cordntc it! shes liek a fuckking prison guard. We dont get a break. Anywya its nice speaking to you all, give you a break from Hitler. I've gotta piss so Im gonna go abut i sned you a song I like under here. Over and out soldier! Fuck y parnets

Nirvana - Smells Like Teen Spirit

This is not a real post

My last post was way too long. Even I was put off proof reading it by the length of it so I totally don't blame you for not reading it. I would normally split a post that long in two but I wanted to get all the fathery stuff out on Father's Day so that I could forget about it all today!
Needless to say, I am glad to see the day over despite having to bite my tongue a few times in work today when people were chatting about it. I felt like telling everyone to stop fucking rubbing it in. Anyway, it's OVER now so let's move on Candy...

This is not a real post. I just felt like reviewing the last two weeks briefly because it is T day again tomorrow. I'm not sure how I'm feeling about going tomorrow. A bit nervous (normally I don't feel nervous in advance: I look forward to going but turn into a quivering bag of jelly as soon as I step into the waiting room) I suppose. I'm nervous in case T wants to talk about the suicide thing again. I feel far from it all now so I don't know if getting myself close to it again will be easy. It stirs parts of me that I like to ignore most of the time.
I'm also nervous because of all the shifting in my mind recently; because I feel less in control of it so more at liberty for others to come out in the session. Others meeting T is something they have wanted to happen and I've wanted to happen but haven't been able to let happen because of a need to monitor and be in control all of the time. I feel my ability to do this may be decreasing and although I think this is a relief in some ways it also makes me more scared because I know it brings the potential for heavy stuff which is exhausting.

I have been in function mode a lot lately (not when blogging but most of the rest of the time), so my feelings about a lot of things are hard to remember. I don't feel pissed off about T's lack of response to my email anymore. Logically I still disapprove but I don't have the feeling about it anymore. I don't feel angry (although I think I probably am still on some other level). I just don't really care. So I'm guessing I might not even mention it. Who knows though; I am so fickle, I could be feeling completely differently in an hour's time never mind tomorrow.

How I've been feeling emotionally of late has been very separate to how my actions would represent how I have been. Does that sentence make any kind of sense? Basically I could say, I'm feeling nothing and not thinking much, therefore things must be OK for me. But if I were to note how I have been in other ways, it's not good. For one thing, the amount of blog posts I have been spewing out suggests that some part of me is thinking, even if in general I feel switched off and numb. My actions over the last while would also suggest something is going on: making myself sick, withdrawing from the world, thinking about death, finding myself awake at all hours, freaking out when someone speaks if I'm not expecting it, crying (I don't usually do that), my general lack of making an effort to look decent most of the time and my overwhelming anxiety at the prospect of doing anything other than lying curled up in a ball when not at work. These aren't such positive signs. I tend to forget about these things and think everything is sunshine and lollipops because I don't feel bad at that particular moment and then I'm surprised when I find myself lying in a heap feeling like I have been sat on by an elephant the next moment.
That's all for now. I suggest you ignore this post and listen to the Doris Day video posted by one of the others. It's much more interesting than my self absorbed tripe. Well, if you've gotten this far, it's obviously too late for that advice. Wish us all luck for psychology tomorrow....

Poem about dissociation: The Struggle

The Struggle

Looking out from up above
Those hands, those feet, the voice
They move and sound so far away
Controlling: not my choice

I hear the cry of one in fear,
She folds herself in pain
I struggle to come down to aide
But struggle now in vain

I'm here but I can't be the one
To hush, to soothe, to see
You call my name, I hear your voice
Though you cannot hear me

What could be done to help me now?
Your question clearly heard
“Please help us, tell her all is safe!”
But I can't speak a word

I need to be the one who's strong
To help her find relief
I'm wading back through treacle sea
To save her from her grief

I'm there and now I look at you
You smile, your eyes are kind
Relief to see me back, but still
I'm struggling with my mind

I'm trying hard to be the one
To feel, to see, to stay
I fight against the pull of tide
The need to drift away

The sands too long have lain asleep
Time gone; I haven't seen
My guilt and shame now burn in me
The burden I have been.

What is dissociation and Dissociative Identity Disorder?

Dissociation is a coping mechanism which allows a person to function normally in difficult situations, by switching off part of their consciousness so that they can function without having to deal with emotions. There are different types of dissociation and different types of dissociative disorders. Dissociative identity disorder (D.I.D) is one of several 'dissociative' disorders and used to be called 'multiple personality disorder'. Its name was changed because it's not technically a personality disorder (because unlike D.I.D I think, if you have a personality disorder, it means you are stuck with it for life: don't quote me on it).

How does D.I.D happen?

If something bad happens to a child they may split off the memory of the event into their subconscious as their ability to process and deal with what happened has not developed. The memories and feelings about it are then held in some other part of the brain and may express as another personality, which the original person is not aware of. This can happen more than one time, so that new personalities form over time. Each part may then contain different memories and emotions and relate to the world in different ways; each part usually has its own function as well.

Basically, the way I understand D.I.D is that we all have 'parts' of our personalities. You might act one way with your partner and another way with work colleagues for instance. But in D.I.D, those aspects of personality have become more separate and so much so that when you are acting in one way, you may not have any memory of the other part of your personality. It is almost like it's a different person. These parts can serve various functions and can be various ages and a person with D.I.D may have any number of parts (also known as 'alters').

A lot of people with D.I.D appear relatively normal; there are more outwardly obvious cases in the media (such as Sybil/United State of Tara) which tend to be a small minority of those who have it. I like to think I appear relatively normal to most people but if you followed me around for long enough you would definitely see that I am not always the way I appear to you. A lot of people may not even be aware themselves that they have D.I.D because it can be so subtle. D.I.D development is useful for a while but once the difficulties that caused D.I.D are no longer an issue, the D.I.D can become more unhelpful than helpful.