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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by Dinah on July 25, 2002, at 14:15:39
What does your therapist do if he can see that at the end of a session you are clearly in a dissociative state and not fully aware of your surroundings? Does he send you on your way as usual? Just wondering if mine follows standard operating procedures.
(By the way, it happens very infrequently with me, maybe two or three times a year.)
Posted by judy1 on July 25, 2002, at 17:29:22
In reply to To anyone who dissociates..., posted by Dinah on July 25, 2002, at 14:15:39
Hi,
It happens the majority of the time with me- just today in fact. Today we walked to the park (my therapist has 2 small dogs) and when she felt comfortable that I was grounded, I left. Normally it adds about 10-15 minutes onto the session, so now I think she plans for it. Take care, judy
Posted by Dinah on July 25, 2002, at 19:45:54
In reply to Re: To anyone who dissociates... » Dinah, posted by judy1 on July 25, 2002, at 17:29:22
I guess I just think it's a bit odd that he recognizes what's happening but lets me loose on the world anyway. Fortunately I don't drive in that state, but he doesn't know that. It's not that I'm asking for extra time, just a quiet place to sit until I can pull myself back into myself.
Posted by judy1 on July 25, 2002, at 20:53:56
In reply to Thanks Judy, posted by Dinah on July 25, 2002, at 19:45:54
I'm sorry- he doesn't do that? Have you asked? What was his reply? Technically he's responsible for your status when you leave a session- I don't know what state you reside in, but that would certainly be frowned on here. Even my shrink insists I rest on his couch outside his office until I'm ready- he recognizes that I may SI or get into an accident- both of which have already happened. I think you really need to talk to your doc and spell out exactly what you need. Take care of yourself- judy
Posted by terra miller on July 26, 2002, at 22:07:06
In reply to To anyone who dissociates..., posted by Dinah on July 25, 2002, at 14:15:39
> What does your therapist do if he can see that at the end of a session you are clearly in a dissociative state and not fully aware of your surroundings? Does he send you on your way as usual?
no way. it's really important to get a foothold on the real world before walking out of the office. if, after his doing his thing (i'll get to that) i am still out of it, he tells me not to drive until i am ready. but at the end of the session- we do this most sessions- he'll start to talk about the mundane day to day stuff... the idea is to bring me back to "reality." it has the effect of shocking me out of the state that i am in because i have to focus on something completely different than where we were at.
sometimes i initiate it. i'll ask for a story (usually if i've been seriously childlike) about something funny that his dog has done recently. he's real good about telling the story in "dad" mode (cuz i'm in still in childmode) but by the end of the story, i've pulled out of it and can get back into the swing of the world. so now it's a cue for us, that if i ask for a dog story he knows that i'm really far gone and afraid that i won't be able to get back out and we both know that the story will do exactly what we need to happen.
i think other standard op. procedures include telling you where you are at, what is going on around the room, etc. sometimes my therapist will bring up my biological kids (ie: "so, what are your kids studying in school?") man, that's a REAL shocker into reality when i'm in a state that i don't know that i'm a mom. that kind of stuff...
terra
Posted by terra miller on July 26, 2002, at 22:13:46
In reply to Thanks Judy, posted by Dinah on July 25, 2002, at 19:45:54
> I guess I just think it's a bit odd that he recognizes what's happening but lets me loose on the world anyway. Fortunately I don't drive in that state, but he doesn't know that. It's not that I'm asking for extra time, just a quiet place to sit until I can pull myself back into myself.
i forgot something. earlier on i would be so upset that i was barely able to pull myself out the back door. lots of times i would sit on the steps in the hallway until i could pull it together. i was visually foggy and couldn't see and thought i would faint any moment. we've gotten really good at moving through the phases, that i forgot that early on it wasn't as easy. and part of it was that i was still too afraid to let him in on what i was feeling... how out of it i actually was. i didn't want to admit and i felt like a 5 year old... that kind of thing; i didn't want him to know. so i wouldn't say anything and then i would be left to pull myself together. i expect that went on for the whole first year at least. i was in total shock for the whole first year of therapy (i've done 3 years.) that i couldn't see straight.
but my therapist has said many times that he wishes at times that he had a gurney so that he could wheel people out into a recovery room until they could go home... he recognizes that it's really hard to make the transition.
terra
Posted by Dinah on July 27, 2002, at 6:30:47
In reply to part 2, posted by terra miller on July 26, 2002, at 22:13:46
>
> i forgot something. earlier on i would be so upset that i was barely able to pull myself out the back door. lots of times i would sit on the steps in the hallway until i could pull it together. i was visually foggy and couldn't see and thought i would faint any moment.Yes, that's it completely.
> we've gotten really good at moving through the phases, that i forgot that early on it wasn't as easy. and part of it was that i was still too afraid to let him in on what i was feeling... how out of it i actually was. i didn't want to admit and i felt like a 5 year old... that kind of thing; i didn't want him to know. so i wouldn't say anything and then i would be left to pull myself together. i expect that went on for the whole first year at least. i was in total shock for the whole first year of therapy (i've done 3 years.) that i couldn't see straight.
>
I guess I need to learn to speak up more too. It usually doesn't happen because I usually keep an eye on the clock and start pulling back in the last 10 minutes or so. But every once in a while he will, in all innocence, say something in those minutes that throws me into dissociating. And it's darn hard when dissociating to have the presence of mind to say "Hey, it's not safe to let me go, could you please plop me down somewhere?" But he does say he can tell when I'm doing it.> but my therapist has said many times that he wishes at times that he had a gurney so that he could wheel people out into a recovery room until they could go home... he recognizes that it's really hard to make the transition.
Ooh. Great therapist. I think mine maybe doesn't work that much with people who dissociate.
>
> terraThanks terra and judy. I'm going to print out your replies, if you don't mind and bring them to my therapist to let him know some things he can do to help.
(By the way, somehow I was able to let my dissociated ego state (it's not really an alter) "speak" to him today. It seemed to really help. I'm going to have to try to remember how I managed to do that.)
Posted by judy1 on July 27, 2002, at 12:08:12
In reply to Re: part 2 » terra miller, posted by Dinah on July 27, 2002, at 6:30:47
You mentioned a dissociated ego state (I guess I'm not familiar with that)- is it a lesser form of an alter? If you allowed this 'state' to speak to your doc, can you speak to this state? I ask because I am starting to be more aware of my internal states, although I've never revealed anything except a child state (and I was completely unaware of what happened). Actually I'm more open with you and Terra than I am with my therapist, I should think about that. Take care, judy
Posted by Dinah on July 27, 2002, at 12:21:38
In reply to Are you able to communicate internally? » Dinah, posted by judy1 on July 27, 2002, at 12:08:12
Oh yes. The two of us have terrible squabbles sometimes. She usually doesn't communicate well with words though. And she is as stubborn as a small child at telling me what is wrong.
I would say it is definitely farther down the continuum than an alter. And the degree to which she is dissociated differs too. Perhaps you've met her during one of my meltdowns? :)
I do think you need to think about being more open with your therapist. Mine knows all about mine and when pinned down, agrees that she is a dissociated ego state but not an alter. But sometimes I wonder if he believes in her at all. On the other hand he can "recognize" her now almost as well as I can. Of course none of this makes any sense to anyone who hasn't experienced it. And if it weren't for you and Terra being so open about it, I would never dream of mentioning it here.
Posted by terra miller on July 27, 2002, at 13:53:34
In reply to Re: Are you able to communicate internally? » judy1, posted by Dinah on July 27, 2002, at 12:21:38
hi girls. :-)
i think there's lots of lingo that means just about the same thing. some therapists talk in terms of ego states or parts of self. some use the word alter (which is just short for the term alternate personality, which is just the same as an alternate ego state.... blablabla) :-)
i don't use the word alter much at all. i think that's because i'm not aware of having alters, (so how the heck would i know if it's appropriate then? silly dissociative circle!)......
anyway..... most of the time i don't believe it anyway. i know that i have a mess of noise in my head, which i can accept.. but it's a lot harder to accept that i relate to my therapist one way and a different way on another occasion (even though i know full well that i've been doing it for years now). he said to me the other day how you just never know, that some sessions i can be so open that i can tell him anything and another session i am so seized up almost catatonic and can't talk about anything, or i may have a bad case of "bloody bad mouth language."
i just try to ignore the whole thing! :-)
but the point of therapy is to face it and let it out, so you and your therapist (to dinah) should not be afraid. think of it in terms of a golden opportunity to figure something out. of course, in the beginning you've got to get past the "what's happening to me/make this stop/i don't trust you/get me out of here/i can't move" feelings. but if you get a good therapeutic relationship going, it's so much easier to let the dissociation happen because you trust yourself in your therapist's hands to not leave you there in that state nor to do anything to harm you while you feel vulnerable. you can get some good work done when you get to that spot. until then it can feel really awful because you're not trusting because maybe your therapist did something to set you off and they have no idea, and you are spinning wondering about all this distrust stuff... and if you don't trust, then how the heck are you supposed to tell them what is going on with you... and you just fall further into the fog. at some point you've got to reach out and hold onto the rope (this is hard), and your therapist has to be there to hand it to you. and your therapist has the responsibility to earn the trust of ALL of you which is an ongoing process.
terra, running at the mouth
Posted by judy1 on July 28, 2002, at 12:19:52
In reply to of ego states and such, posted by terra miller on July 27, 2002, at 13:53:34
Hi terra,
thanks for explaining the different terms- they do sound like they mean the same thing. It's funny when Dinah mentioned the noise in her head, I thought everyone had that- but wasn't sure, and wasn't about to risk the question. So I think your last paragraph may have been directed more at me then Dinah- the trust issues, and how truly difficult and draining it is to keep a clamp on everything in front of my therapist who I know is trying to help. Now my shrink... he doesn't accept DID, which doesn't matter because I got the DD-NOS label (which doesn't matter either) judy also running off at the mouth :-)
Posted by Dinah on July 28, 2002, at 15:13:25
In reply to of ego states and such, posted by terra miller on July 27, 2002, at 13:53:34
I guess the reason I made a distinction between a dissociated ego state and an alter is that I don't meet the criteria for DID. I always have co-consciousness, never lose time, etc. Also my inner self is in no way a complete stand alone personality, if that makes any sense.
And if it does, explain it to me please. :)
Posted by terra miller on July 29, 2002, at 17:14:13
In reply to Re: of ego states and such » terra miller, posted by Dinah on July 28, 2002, at 15:13:25
> I guess the reason I made a distinction between a dissociated ego state and an alter is that I don't meet the criteria for DID. I always have co-consciousness, never lose time, etc. Also my inner self is in no way a complete stand alone personality, if that makes any sense.
>
> And if it does, explain it to me please. :)
<<giggle>>yea, i get it. do you know what would happen to me if i decided to adamantly say that nobody else "completely stood alone?" that's probably the big clue. lots of DID folks are co-conscious. i'm mostly (i think....) that way ... some of the time..... anyway, the big give away is when the opinions become ways of life/living/speaking/viewing things. then you've got DID.
Posted by Dinah on August 2, 2002, at 20:57:26
In reply to Re: of ego states and such » Dinah, posted by terra miller on July 29, 2002, at 17:14:13
> yea, i get it. do you know what would happen to me if i decided to adamantly say that nobody else "completely stood alone?" that's probably the big clue. lots of DID folks are co-conscious. i'm mostly (i think....) that way ... some of the time..... anyway, the big give away is when the opinions become ways of life/living/speaking/viewing things. then you've got DID.
>
>
>Hi again Terra,
I was hoping you could help me out a little. I have a couple more questions for you, if I'm not being a horrible pest. I found out today that my therapist suspects I am a bit farther along the dissociation continuum than I had thought. :)
I don't know whether he came to that conclusion before or after "she" had a complete conversation with him (rather than just the short frantic phone calls).
Could you explain a bit more what you meant above? Do you mean that the other parts of you can stand alone? And I always kind of thought co-consciousness ruled out DID. Even when "she" spoke to him, I was right there alongside, rather disconcerted. I deliberately stepped aside to let "her" speak, and I could probably have stopped the whole thing if I had wanted to. And even during it, I had doubts about how real it was. Do you think it's even wise to try to step aside? "She's" been clamoring for more air time ever since.
Thanks for bearing with me on this. I think my therapist is afraid to talk to me too much about it for fear of upsetting me.
Dinah
Posted by judy1 on August 3, 2002, at 12:00:14
In reply to Re: of ego states and such » terra miller, posted by Dinah on August 2, 2002, at 20:57:26
I'm interested in terra's views- but really curious why you think your therapist is afraid of upsetting you. Will you get upset if she brings it up? Is being a little further on the continuum upsetting to you? One of the givens about DID is when you are more comfortable with your therapist, the more comfortable you are in allowing your alters or ego states or whatever name is comfortable for you to speak or 'get more air time'. It is a constant battle for me to keep the clamoring in my head hidden from my therapist, but that is MY lack of trust- certainly nothing she has done. Do you feel your therapist will be unsupportive? Please take care, judy
Posted by Dinah on August 3, 2002, at 12:20:41
In reply to May I interrupt? » Dinah, posted by judy1 on August 3, 2002, at 12:00:14
Always glad to have your input Judy. I know we struggle with a lot of the same issues.
I'm not enormously sure why he's afraid, except that I've always qualified my statements to him that I don't have DID, which I really don't, for the simple reason that I'm pretty sure the DSM-IV requires that you lose time. Or at any rate I remember there is something there that I didn't fit. But I'm pretty sure he's also afraid to upset "her", which is a general sort of thing, because upsetting "her" always causes problems, and I think he tiptoes around sometimes.
Now why he's afraid that his thinking she is "real" would upset her, I don't know. She's the one who always wanted to continue seeing him, she's the one who always trusted him, and she's the one who felt he "saw" her even before he thought he did. She's delighted. I'm a bit frightened I suppose. And I still don't know how real it is. I also am never sure how he feels about DID or DD-NOS, as I know it's an area of controversy. And I wasn't sure if he even wanted to talk to her separately. We discussed that yesterday, and I feel a bit more comfortable that it's okay with him, although he did say opinion was divided on whether or not a therapist should speak to different parts of the personality. But he said if she wanted to be heard, he wanted to hear her. And he mentioned what he mentioned a while back, that he had once worked with a pdoc who did have some DID patients, and had worked with them before. But he's still tippytoeing about somewhat and not making direct statements.
I don't know. I know that the separation is a skill I learned, along with my other dissociative skills, and I'm not sure whether it should be considered a disorder at all. I was old enough when I learned to dissociate to know what I was doing. So I think if anything it should be something like disssociative dysfunctional defense mechanism.
No, I don't know what to think. I just know that she is an internal phenomenon and that no one other than me and my therapist (and now the entire internet - grin) knows about her. So I don't know that she qualifies as a separate personality. Moreover neither she nor I am a complete personality. She's got the emotions and I've got the reasoning. And maybe the distinction is an artificial one and there is no her at all. A lot of times I really think that. But...
Oh it goes round and round.
Posted by terra miller on August 5, 2002, at 17:10:34
In reply to Re: May I interrupt? » judy1, posted by Dinah on August 3, 2002, at 12:20:41
one of the qualifications/requirements/whatever for DID is that some extreme trauma happened to a child 7 years or younger. before the age of 7, the brain is able to pull it off. after the age of 7, the brain/ego/whatever is more permanently formed. that is why adults can dissociate but they can't "create" DID. it's not possible. someone creates it as a kid in order to survive some terrible trauma because it's all you thought you had left to do (felt no way out).
about lost time: this feels different to different people. generally speaking, it feels more like just not being able to remember something. it's very common to hear someone say that they can't recall anything from their childhood at all. or they can't recall two entire years. usually the dissociating functions at such a high level that you aren't aware of it (which is the entire purpose.) it's not until you get into therapy, or enter it because you think you are going crazy, that you begin to recognize "waking up" in the middle of your day and stuff like that. before starting to catch on, you have absolutely no clue that anything out of the ordinary is happening. after all, this is ordinary to you because it's what you've known your whole life. it's just that eventually it starts to break down because it's not needed anymore, and then you march into therapy.
fwiw.
terra
Posted by Dinah on August 5, 2002, at 17:52:04
In reply to fyi, posted by terra miller on August 5, 2002, at 17:10:34
I'm sorry if my questions were impertinent. I'm just trying to come to a new understanding of something I thought I more or less understood.
No extreme trauma at all in childhood. Certainly none before age 7.
Maybe I'll eventually be able to frame it in a way that makes sense to me.
Weak smile,
Dinah
Posted by terra miller on August 5, 2002, at 23:41:00
In reply to Re: Thanks Terra...., posted by Dinah on August 5, 2002, at 17:52:04
not impertinent at all. actually, i am extremely happy for you about the no childhood trauma before age 7. it had just occured to me that these were primary details that i didn't mention before is all.
take care.
terra
Posted by Dinah on August 6, 2002, at 17:42:53
In reply to dinah, posted by terra miller on August 5, 2002, at 23:41:00
Sorry if I was a bit short. I'm having a bad case of babblers remorse about bringing up what happened. Apparently "she" isn't too happy about my discussing her. :(
Plus I was re-reading the Myth of Sanity, and as before it was causing some nasty reactions.
Thanks for the information. As always you were very helpful.
Dinah
Posted by terra miller on August 6, 2002, at 21:22:57
In reply to Re: Terra, posted by Dinah on August 6, 2002, at 17:42:53
> Sorry if I was a bit short.
didn't seem short at all to me
>I'm having a bad case of babblers remorse about bringing up what happened. Apparently "she" isn't too happy about my discussing her. :(
oh man, been there/done that. from my experience it's a good idea to go with it. sometimes you can make deals. you give some/she gives some. the more you listen, the more respect you get. validation is everything; validation and respect. you respect her and then you realize all of sudden that you seem to respect yourself more. it's a cool process.
take care.
terra
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