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.

It's a crash

Dear world

I am still alive. I think I must be because the pain in my heart would suggest it hasn't died. My husband picked up some sleeping tablets from the doctor I spoke to yesterday and I took one last night. I slept for ten hours although I still feel knackered today and unfortunately, still in a dark, despairing, empty, alone place. It's a crash.

I lay on the sofa again this afternoon for some time while Adam tried to cheer me up by playing some jolly tunes on the piano. He said he wanted to go and play golf today with a friend. I really felt down when he said this. I don't want to be alone again after spending most of the day on my own yesterday. A small part of me felt sad that he couldn't understand how hard things are for me at the moment. I guess he's so used to seeing me with something or other wrong: if it's not feeling sick, or random body pains, it's exhausted or depressed; that he doesn't really distinguish the crisis I am having as different. But yet he does, because he keeps saying how worried he is and he rang my psychologist and he knows I wouldn't contact the out of hours GP if I felt it could wait until Monday. This is more than depressed. This is a crash.

If you read the comments section on yesterday's post you'll know already that I contacted the out of hours GP yesterday and he was very kind and tried to be understanding although didn't really understand at all. He gave me lots of useful advice like drink ten glasses of water per day and eat my five a day fruit and veg. I know when you're in the middle of a crisis, eating your five a day isn't the answer, but that's OK. It's still important sometimes to hear the basic advice. I know as well as anyone about the importance of these things but even I find myself sitting on the sofa at 7pm realising I haven't eaten or drank since I woke up that morning. So he had a point. It's just not going to solve my crisis and I wanted something much more immediate than lifestyle advice. He advised me to keep taking the diazepams which I had from my GP ages ago and hadn't found any use. He said to up the dose to three tablets as and when and he prescribed the aforementioned sleeping tablet, which after reading the side effects of, I wondered if was going to do me more harm than good taking it and went to sleep half expecting to wake up this morning in a psychotic state having lost my memory and end up running round aggressively attacking people with a bat.

After I while of being sprawled on the sofa today I asked Adam to ring the doctor again because I am sure diazepam doesn't help someone who is in the depths of despair. He did so and spoke with a doctor on my behalf. I could hear him talking about how I have DID and depression and I wondered if the GP would have a clue what DID was. I don't think I would have mentioned it myself. I could hear the GP asking Adam if I was having thoughts of self harm or suicide and Adam said he didn't think so. I suggested I speak to the doctor and we chatted for about ten minutes. He was very friendly again, which again surprised me. I've only ever had to ring an out of hours GP once before and that was when I ran out of antidepressants just before a bank holiday weekend and wanted to get some more in case I would have withdrawal. The GP was so rude and patronising and gave me a stern lecture about being responsible for my own health. It was like a slap in the face for someone who, I think given my difficulties is doing a pretty good job at managing and being responsible all in all.

Anyway, this doctor seemed to be very understanding of the crisis I was having. He agreed that diazepam probably isn't going to help me much and that although he wished he could give me something to help me feel better through the weekend, that there really isn't any short term medication for the type of feelings I am having. He talked about how I had been in therapy for three years and that this must be very difficult and bring up a lot of things for me. He said he understood that sometimes things can become overwhelming and very intrusive and that an antidepressant would be something I should consider although it probably wouldn't help me today or tomorrow as it could take a few weeks to kick in. I expressed that I am worried about work because even this weekend there is a lot of work I need to do because of deadlines coming up and he said it was important not to think about these things but that my health is a priority. He's about the fourth person to say that to me in the last week. Even my own manager suggested that I need to put my health first and consider leaving work for a time. It's just not an option though. Adam is out of work and we have a mortgage to pay. I'm trapped. I can't really talk to Adam about this because he feels it's his fault for not being in a job. Sigh.

In the end we left it that if the thoughts were becoming very intrusive, I should contact them again. I'm OK with that. I know I'm not going to kill myself this weekend. I guess I just need to try and cope and do the things like drink water and eat fruit. 

Afterwards I asked Adam how the GP had reacted when he talked about DID and Adam said he seemed to have a good understanding of it which surprised and pleased me. I guess that's why he seemed to have quite a good insight into how I was feeling when I tried to explain that these crashes are usually short lived and most of the time I'm like 'a different person'. It felt really good to speak with someone who was caring and compassionate and not judgemental and ignorant. GPs can't be all bad.

The sun is shining here, for a change. My husband has realised I need him not to go out to play golf (I didn't want to say but I was hoping he wouldn't abandon me today so it's a relief) and instead we are going to walk up the hill behind my house and have bacon sandwiches by the lake in the meadow. You wouldn't think I live in the capital city! I just need to muster up some energy to get out of my pyjamas into some clothes which seems like a simple enough task but feels mammoth.

I'm supposed to be going out for dinner with Adam, my sister Katie and her husband tonight. I know it's probably good if I do get out and could help me feel better, but between you and me, the thought of having to take a shower and find some clothes to wear is overwhelming me!

Thank you for the encouraging comments on the last post. It really does help to hear from others who know what it's like. I feel for anyone who goes through life feeling the way I am this weekend.

Nightmares and Daymares

I've been feeling ill the last few days. I'm not sure if it's because of an actual infection of some sort or if it's stress related. I haven't had much sleep lately so it could be over tiredness. At the moment I have some bad stomach cramps but at least my headache has eased off thanks to my old friend ibuprofen (I should buy shares).

The last week or so I have been having really weird dreams. I can't always remember them well but I wake up with a sense of something strange having been the content. Sometimes I dream that I have to engage in some kind of sex with someone from my family (not always the same person but usually one of three specific people). Obviously, this is really disturbing and I feel freaked out at the prospect. In the dream though I am always just trying to get on with it and get over the feelings of repulsion because I know it is something I 'should' do. I never stop and think: "Hang on, this isn't something I 'should' do; this is really wrong. Why don't I just say 'no'?"

I've had this dream a few times over the last week. It's horrible and scares me. The images of last night's version of this dream keep popping into my head today: trying to kiss that mouth when I want to run away; my body doing all the right things while my mind is screaming for me to stop. The scenes don't just go through my mind as dreams, sometimes they're there when I'm awake, like a waking dream that I can't stop. They are more likely to happen when I'm eating; if someone touches me (e.g. if a family member gives me a hug or if Ad wants to be intimate) or if I hear about 'bad things' (I still can't type those words).

It's hard to think about all of this and stay focussed. Thinking about it makes me feel ill. A lot of my energy in life goes into avoiding it. Today I seem to be braver than other days. I am able to write about this without really allowing the images to interfere too much at the moment. When I can tolerate thinking about it, I try to push how long I can stay on the subject. Most of the time when images like that come into my head I block them out as quickly as I can or I feel too anxious and sick. Sometimes though (not very often) I feel stronger and try to look at them and keep my mind open. I tell myself: "Try to remember." Sometimes I feel like I'm right on the edge of remembering but it always gets too scary and I shut it down again. I don't think I'll ever be strong enough to get through that. Or maybe there's nothing to get through.

Despite all the intrusions of images, the feelings in my body, the anxiety and the other people inside me who are so troubled, who the research would say are there as a result of something bad happening... I still end up thinking that it's not possible that those things could be real. I still tell myself I've made it all up. I know my parents loved me. I know they did their best for me. I can't see how those things could fit in. But there are bad things I do remember and how do they fit in with 'love'? I go round in circles.

That's enough now.