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Dr. Bob is Robert Hsiung, MD,
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Posted by judy1 on February 12, 2005, at 14:17:07
In reply to Regarding voices, posted by gardenergirl on February 12, 2005, at 8:35:14
Having experienced both inner and outer voices, I would agree with what you wrote. The 'outer' voice has occured during manic (psychotic) episodes and ended when the episodes did. The 'inner' voices have been a part of my entire life- I have a DD-NOS diagnosis along with bipolar 1. Honestly, I feel I would be alone w/o the inner voices.
Posted by judy1 on February 12, 2005, at 14:29:22
In reply to Re: p-doc and coming assessment » Pfinstegg, posted by alexandra_k on February 11, 2005, at 20:49:28
It's been really helpful reading your dialogue with Pfinstegg, thank you for posting. I have several thoughts- I agree with losing the BPD label, it's often a detriment in getting a good therp for a dissociative disorder. I'm sorry there is such a scarcity of 'experts' in that field in NZ, I wish you all the best in finding someone to work with. My therp actually has DID, so I obviously lucked out. I found her by reading books on the subject and discovered her living in my area. After that I called her and we went from there. While I do not have DID, I do have DD-NOS and experience fugue states. I have seen her (more off then on) for about 3 years and in that time we have only worked on safety and trust. The best aspect of that (for me) has been a lessening of symptoms. Perhaps just knowing she is available to me and having her treat me like a 'normal' person has been the reason. I need to mention that my ex-pdoc does not believe in DID and she and I have had a few laughs about that.
When I decide to deal with my past (I used to say 'if') I know it will be with her and I understand it will take a great deal of time and work.
I wish you all the best- judy
Posted by Dinah on February 12, 2005, at 17:49:20
In reply to Re: p-doc and coming assessment » alexandra_k, posted by Pfinstegg on February 11, 2005, at 16:51:28
Pfinstegg, this is probably an incredibly rude question, and if so feel free to ignore it.
But I was wondering why you always leave me off the list?
Posted by Pfinstegg on February 12, 2005, at 23:04:56
In reply to Re: p-doc and coming assessment » Pfinstegg, posted by Dinah on February 12, 2005, at 17:49:20
Dinah, I had no idea I was leaving you off any lists, but I do see that I thanked three people about the "thanking therapist" thread, and then left the house for about eight hours. When I returned and checked in, I saw your lovely and very warm post in response- thank you so much for it! I actually always love talking to you here; but it is true that we haven't talked together directly lately. Sometimes, we are on the same threads, but seem to be focussed on another person. Then, it doesn't seem quite right to "highjack" it to talk directly to one another. I'm so sorry that I haven't been posting more directly to you, and would love to do so in the future. I can promise you there was no intentional avoidance- i think I get distracted because of my own difficult issues, and also because I sometimes try to focus on an issue that is currently very difficult for someone else. You have been so great- really the steadfast brains and heart of the board- and I would never want to cause you any hurt or distress. I must have, but I did not mean to. I hope you'll forgive me, and that we can continue having great discussions here.
Posted by Dinah on February 12, 2005, at 23:16:42
In reply to Re: for Dinah » Dinah, posted by Pfinstegg on February 12, 2005, at 23:04:56
Oh Pfinstegg, no. That wasn't what I was suggesting. Oh, it all seems so silly and petty now.
I just had noticed in the past that you never refer to me as one of the dissociative posters on the board, that's all. Not that you were ignoring me or anything. I'm reasonably insensitive about things like that. Especially with someone I've had a long relationship with, as I have with you.
No, it was more a question of identification. I always identify very strongly with Daisy's little Daisy particularly. Despite the lack of severe trauma in my childhood. I was just wondering if you saw major differences in how we present ourselves, other than the lack of childhood trauma. And perhaps the fact that I backpedal as much as I forward pedal.
It wasn't a personal question at all. Not personal in that way. It was more of an inquiry. But since it called for a personal opinion from you, I wondered if it wasn't rude to ask.
(And of course I always enjoy talking with you. And I'm always glad to hear I haven't offended someone.)
Posted by Pfinstegg on February 12, 2005, at 23:47:10
In reply to Re: for Dinah » Pfinstegg, posted by Dinah on February 12, 2005, at 23:16:42
Oh, I see what you're talking about Dinah! For whatever reason, I thought you didn't have a dissociative disorder, so I wasn't including you because of that idea. I know you have mentioned having "emotional" and a "rational" selves, but that seemed more *normal*, and to be expected, than what Daisy, Alexandra and I were talking about. We seem to have different selves with completely different agendas, which sometimes seem to be at war with one another. Daisy has never said that she loses time, and can't account for it, but Alexandra and I have both had that happen; it is still happening to her, but I think I've gotten over it, having had such great therapy, which she hasn't been able to obtain yet. I am becoming convinced that people almost never dissociate unless they have been sexually abused as children. Being neglected, terrified or hit, have terrible consequences in later life, but I don't think those things cause true dissociation. I think they tend to diminish a person's sense of self-mastery and confidence- they often cause tremendous anxiety and depression, but I don't think they cause people to *break apart* the way sexual abuse apparently does. But assuming this is true, there are bound to be exceptions. The truth is, Dinah, the dissociation club is not exactly the one anyone wants to belong to!
Posted by alexandra_k on February 12, 2005, at 23:55:11
In reply to Re: for Dinah » Dinah, posted by Pfinstegg on February 12, 2005, at 23:47:10
I wasn't sexually abused.
Posted by Dinah on February 13, 2005, at 0:03:33
In reply to Re: for Dinah » Dinah, posted by Pfinstegg on February 12, 2005, at 23:47:10
> The truth is, Dinah, the dissociation club is not exactly the one anyone wants to belong to!
Goodness only knows I know that. That's why I'm always so indirect. At times I'm not indirect at all, to my thinking. And I usually end up thinking I'm scaring people. So I backpedal, because it doesn't feel safe to be honest.
> I know you have mentioned having "emotional" and a "rational" selves, but that seemed more *normal*, and to be expected, than what Daisy, Alexandra and I were talking about.
I think it's word choice perhaps, more than genuine difference.
> We seem to have different selves with completely different agendas, which sometimes seem to be at war with one another.
I think I can safely say that. I could safely say a lot more than that even. Well, not safely. That's the whole point. But I can honestly say that and more. I just generally prefer not to. :)
Posted by Pfinstegg on February 13, 2005, at 0:04:28
In reply to Re: for Dinah » Pfinstegg, posted by alexandra_k on February 12, 2005, at 23:55:11
Oh, OK. I thought it had happened to you in your early teens. I must have misread, or misunderstood, your posts from a month or two ago.
Posted by alexandra_k on February 13, 2005, at 0:10:51
In reply to Re: for Dinah » Dinah, posted by Pfinstegg on February 12, 2005, at 23:47:10
I believe dissociative disorders (just like mood disorders and other kinds of disorders) are on a continuum with normal functioning. Some people have *more* of a problem and others have *less* of a problem that is true. But there is no radical difference in kind between those with and those without. And there can be a fuzzy middle area where it can be genuinely indeterminate.
I appreciate most disagree with me - but I don't care.
I have reasons to believe all that - but I won't go there today.
One woman claimed her alternative identities developed when her father used to pretend he was abusing someone else.
Some people claim that people develop alternative identities later in life when they try to make sense of their experiences.
Some people claim that people develop alternative identities still later in life when their therapists suggest this way of making sense of their experiences.But what is the difference? It is a way of making sense of ones experiences. Some people may have more or less extreme experiences to make sense of but it is a way of making sense of them.
A difference in degree not in kind.
The trouble with taking sexual abuse to be a causative factor in *any* psychiatric / psychological diagnosis is that the clinician who buys into that will believe there must have been abuse. The client who buys into that will believe there must have been abuse.
Let the Freudian error not be repeated:
'I no longer accepted her declaration that nothing had occurred to her, but assured her that something *must* have occurred to her... Finally I declared that I knew very well that something *had* occurred to her and that she was concealing it from me; but that she would never be free of her pains so long as she concealed anything. By thus insisting I brought it about that from that time forward my pressure on her head never failed in its effect (Freud, 1953-74 in Webster, 2003 p.11)
After that performance is it any wonder people come up with stories of abuse?
When clinicians and clients both believe that it must have happened in order to justify their present distress????I think these may have been the cases Freud had (or at least should have had) in mind when he recanted that sexual abuse claims were true...
Posted by alexandra_k on February 13, 2005, at 0:13:14
In reply to Re: for Alexandra, posted by Pfinstegg on February 13, 2005, at 0:04:28
> Oh, OK. I thought it had happened to you in your early teens. I must have misread, or misunderstood, your posts from a month or two ago.
Sorry.
I guess I vaccilate about whether it counts as abuse or not.
It doesn't today ;-)
ok?sorry...
Posted by alexandra_k on February 13, 2005, at 0:17:49
In reply to Re: for Alexandra » Pfinstegg, posted by alexandra_k on February 13, 2005, at 0:13:14
Posted by Pfinstegg on February 13, 2005, at 0:19:26
In reply to Re: for Dinah, posted by Dinah on February 13, 2005, at 0:03:33
I didn't know that you really thought you had it, also- now I understand much better. I think it can be very hidden- it certainly was for me for many, many years. I put up a huge fight about it when my analyst began suggesting it, so much so that he used to tease me that I had almost, but not quite, convinced him that I didn't have it! But, as I've begun accepting it, and trying to express and understand it, I really am feeling a lot better. Now, I really respect him giving me that diagnosis.
Posted by Pfinstegg on February 13, 2005, at 0:23:57
In reply to Re: for Alexandra » Pfinstegg, posted by alexandra_k on February 13, 2005, at 0:13:14
Definitely OK
Posted by alexandra_k on February 13, 2005, at 0:29:49
In reply to Re: for Alexandra, posted by Pfinstegg on February 13, 2005, at 0:23:57
I am sorry...
(Watch me rationalise)...
Posted by Pfinstegg on February 13, 2005, at 0:47:15
In reply to Re: Pfinstegg » Pfinstegg, posted by alexandra_k on February 13, 2005, at 0:29:49
Don't be. Take your time with everything.
Posted by Dinah on February 13, 2005, at 2:28:28
In reply to Re: for Dinah, posted by Pfinstegg on February 13, 2005, at 0:19:26
I'm a contrary wench. It terrifies me to think of myself as getting that label, but it also makes me feel ashamed that I need to hide it. So I periodically get angry and refuse to hide. Then regret it.
I can't say my therapist ever encouraged me. He downright discouraged me until I told him he was hurting my ability to communicate effectively by having to talk around the issue.
Posted by Pfinstegg on February 13, 2005, at 9:23:40
In reply to Re: :-) » Pfinstegg, posted by Dinah on February 13, 2005, at 2:28:28
I thought Alexandra gave an excellent overview of dissociative disorders on a gradient from minimal to severe. I'm sure she's right that it's a coping mechanism for ANY kind of trauma- neglect, physical abuse, emotional abuse as well as sexual abuse. If any of those causes overwhelming distress, the response could be to dissociate- leaving a younger part of ourselves to bear the fear and sadness, so that an older part can go out in the world with enough confidence to do well. I am so astounded to be just now remembering sexual abuse that occurred when I was six that I think I over-emphasize that as a necessary causative factor. I guess the best way to look at dissociation is as a generalized brain response to overwhelming stress suffered by a child, adolescent, or adult (war veterans).
If you are beginning to suspect that you do dissociate, are you getting a helpful response from your T? I 've found that the T needs to be confident in his own mind that you have it, in order to deal with with the adult part which keeps saying, "never! Of course not!" as well as the child part, which keeps remembering and forgetting, then remembering again.
Posted by Dinah on February 13, 2005, at 10:11:43
In reply to Re: :-) » Dinah, posted by Pfinstegg on February 13, 2005, at 9:23:40
I don't think that my conception of my degree of dissociation has changed in eight or nine years, maybe more. As soon as I started giving thought to what was going on inside when I started therapy. Before that, it never much occurred to me that my behavior and thought processes were out of the ordinary. I grew in my understanding and ability to verbalize because I started out with very little vocabulary on the subject, but the basic ideas have pretty much remained unchanged.
It took my therapist another couple of years to be comfortable with my talking about it in a direct way. By that time, he realized that my ego state structure was quite stable and he wasn't afraid of "encouraging" polyfragmentation or anything. I know, I'm not proud of him either, but it is the prevalent thinking.
Since then he's been terrific about it. He does have experience in the area, although his experience left him more cautious than eager. But he is very accepting, and understands my goals.
Posted by littleone on February 13, 2005, at 15:53:22
In reply to Re: for Dinah » Dinah, posted by Pfinstegg on February 12, 2005, at 23:47:10
The other day I had a really bad session with my T and in it he was saying over and over that I have a shattered ego. And that he believes I am in the PTSD/BPD/DID spectrum, ie I have a problems with my sense of self.
Anyway, it all scared me to death and of course I've been reading up on this stuff and something really worries me.
I've read about Dissociative Compartmentalization and it sounds just like my boxes and how I shove things away. And I know that everyone is able to turn away from unpleasant things. But I worry that I am *too* good at doing that.
I was just wondering what you guys are like with this aspect of the dissociative disorders.
Posted by daisym on February 13, 2005, at 18:32:52
In reply to Dissociative Compartmentalization, posted by littleone on February 13, 2005, at 15:53:22
I'm sorry you are worrying. Actually, the skill to compartmentalize often comes in very handy. It allows you to focus on things and not be distracted with all the background memories and feelings. I'm so, so good at this. I can teach classes or give presentations and be completely "in the moment." That is why I like to be in charge. If I'm sitting and my mind has time to wander, I get whammied with thoughts or feelings I'd rather not have. I think many people think I'm a cold, unfeeling b**ch because I can even put away things like my husband being in the hospital, or other personal issues. I think this is why I can (usually) go back to work after therapy. And this is one of the skills that is not as strong as it used to be as I get further into "my stuff". I complain about this to my therapist all the time.
Is the problem that you put stuff away and don't ever sort it out, or don't go back to it? The usual thought is that you will when you are ready. I think sometimes we who are really good at compartmentalizing need a little help in this area. I think that is why depression sets in...all those boxes get too full and some of the feelings leak out.
Is this what you mean?
Posted by Dinah on February 13, 2005, at 18:50:52
In reply to Dissociative Compartmentalization, posted by littleone on February 13, 2005, at 15:53:22
I can "forget" things, if that's what you mean. I don't necessarily forget that they happen, but I strip them of all meaning.
Posted by littleone on February 15, 2005, at 15:09:03
In reply to Dissociative Compartmentalization, posted by littleone on February 13, 2005, at 15:53:22
Thank you for your replies. I do mean what both of you said, but also more. I don't really know if this is a freaky thing, or just normal. And I can't explain it very well.
If something makes me antsy or upset, I can just shove all thoughts of it away. Sometimes it's like a mental shove and sometimes I lock things in a mental box. Once they've been shoved/locked away, it's like what Dinah said. I can forget them, but still know they happened. And they are stripped of all meaning. Sometimes I can take something out of the box and there will be no feeling attached to it. It's just a thing.
But usually, once something is gone, it stays gone. Unless something triggers it off and it hits me all over again and then I need to work at locking it back up.
Normally locking things up doesn't take any thought or effort, it just happens. It's only recently that I've been able to consciously lock something away.
But it's a lot more than that. My feelings are compartmentalized too. I get all antsy just trying to write this. Sorry, I can't expand on this point.
I think too that my identity is compartmentalized. I know that everyone has a variety of identities/faces, eg workmate, daughter, mother, sportsplayer, friend, etc. And that these identities are pretty separate. But I kind of get the impression that they should be a little flexible if need be. Mine are completely separate and different and . I'm not explaining this very well. I guess mine are just separated by a fence/wall. Mine are all on different planets.
I just feel wrong inside.
Posted by Dinah on February 15, 2005, at 17:30:25
In reply to Re: Dissociative Compartmentalization, posted by littleone on February 15, 2005, at 15:09:03
I don't know if this is part of what you mean, but my life ends up being very disconnected - sort of chopped up. I don't have any enduring sense of myself or my history or even what happened last week.
This moment seems like the only real moment that ever was, but in an hour, this moment will seem as unreal as any other.
The only thing that anchors me at all is my connection to others.
I don't know if that's anything like what happens to you.
Posted by alexandra_k on February 16, 2005, at 0:54:12
In reply to Re: Dissociative Compartmentalization » littleone, posted by Dinah on February 15, 2005, at 17:30:25
Sometimes I become aware of something. It can be a memory, or a feeling associated with a memory, or certain thoughts, or all of the above. I can kind of refocus on something else and sort of 'prevent' it from resurfacing. After a couple of 'preventions' it doesn't (hardly ever) come back up.
I don't think I would be able to function very well without that. Like Daisy said, it is what lets you carry on...
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