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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 35. This is the beginning of the thread.
Posted by Pfinstegg on July 28, 2004, at 18:16:49
There have been several wonderful, thoughtful posts here lately, with posters describing impressive levels of insight and courage in exploring new areas within themselves, as well as wonderful examples of excellent therapists at work. I don't have anything quite comparable to offer, but wanted to share a bit more of my own experience as someone with a dissociative disorder being treated by a psychoanalyst. I don't have actual DID, but rather a normal-seeming adult self which functions well in marriage, motherhood and a university career in science, However! I am constantly fighting down really severe anxiety (real fear) and depression. I didn't know it when I started therapy, but I have discovered that I have actually walled off my infant and childhood experiences, which included severe maternal neglect, and, later, an alcoholic father who was sexually and physically abusive. I seem to have gone into a sort of daze during my entire childhood, emerging as a teenager and, later, adult who seemed to have everything going for her- brains, good looks (yes, I'll say it!), and a personality that people were drawn to.
When I first went into analysis a year and a half ago, I was trying hard to keep that adult in place in therapy, too. Gradually, that has given way; it's as if the walled-off, dazed infant and child have come to life. *They* feel very separate from me- they really are suffering children who didn't get to grow up. Now, they are fully present in the analysis. I don't think I have ever experienced such fear, grief and sorrow in my entire life. But, I do think it's a big step to experience these real childhood feelings, rather than the anxiety and depression which were signallling their existence
It's as if the infant and the young girl have to start from scratch in learning to relate to the analyst. At first, when those parts surfaced, they felt completely alone, detached and grief-stricken. On the couch, I would turn my face away towards the wall and just sob. I felt like I was dying of a broken heart. Very slowly, they are beginning to relate to the analyst- they have moments of trust and closeness, followed by more distrust and withdrawal almost instantaneously. Back and forth- they have a long way to go in building a secure attachment, and in discovering what their desires and wishes are. In the process, too, they have to discover a lot more painful details of what actually happened to them that was so destructive. I'm calling them *them* because, although I, as the adult, know and understand about their experiences, they, as the children, don't know anything much about the adult me.
My analyst is absolutely wonderful in helping me sort all this out. He is always extremely gentle and tender towards the child
parts, trying to let them know that they have a safe person to be with. He is just very empathic by nature, but, when the adult part is there, he relates to her (me!) in a more complex, humorous, sharing way.I guess our eventual goal will be to dissolve the separations in me which have occurred. But, for the time being, my analyst is intent on speaking directly to the child parts- giving them their first safe, loving experience. My part of the work is just to let them be there as fully as possible, and to experience their pain- not alone this time, but with him. That is the vital key to everything that is happening in my therapy- the connection to him.
Posted by Shadowplayers721 on July 28, 2004, at 18:55:31
In reply to Being treated for a dissociative disorder, posted by Pfinstegg on July 28, 2004, at 18:16:49
Wow! You are in the midst of doing some powerful work. I have been dx with DID/MPD years ago. I never wanted to face up to it, but the symptoms have always been there. They were there since childhood.
I think I know what you are talking about with the grief. I was in the t's office yesterday telling her that I feel like a broken toy. There is NO WAY that I could have gotten through brutal abuse without dissociation. It's just not possible. I felt like a 10 pound weight was on my head. The sadness is just overwhelming.
Therapy is difficult for me these days, because at times I am unable to speak. Something totally different will come out of my mouth or I will not be able to say words or read things right. It feels like I had a stroke.
You must have a great relationship with the analyst for you to be able to get to this point. That's awesome for you. It's terribly hard work emotionaly.
Posted by Pfinstegg on July 28, 2004, at 19:31:30
In reply to Re: Being treated for a dissociative disorder, posted by Shadowplayers721 on July 28, 2004, at 18:55:31
It sounds as if you are doing the same deep, powerful work that I'm trying to do. You are right- it is very, very hard. Some of the things you describe- being unable to speak, or suddenly saying something that one's adult self thinks is very strange- happen to me, too, all the time. My analyst welcomes the strange outbursts, as he feels that they are coming from dissociated parts which are gradually becoming more present in the therapy. The adult part of me sometimes feels that I am "losing it" altogether, and just turning into an incomprehensible mess, but I am trying to learn to welcome these unfamiliar parts, and to understand and comfort them, as he does.
I wanted to describe what my illness and therapy is like, as I think it is very easy to overlook dissociative disorders; possibly many more people have them than even therapists realize. WE don't want to know about it, and, from my own experience, previous therapists I've had have never diagnosed me with it- I don't think it crossed their minds, as I. to surface appearances, was high functioning, and was trying so hard to be *together* all the time.
I am finding that, as I am becoming better able to allow all the parts of me into the therapy, that my depression and anxiety are improving, and that I don't feel that I am carrying such a heavy burden of pain. I do hope the same is true for you. Glad you wrote!
Posted by gardenergirl on July 28, 2004, at 21:30:35
In reply to Re: Being treated for a dissociative disorder » Shadowplayers721, posted by Pfinstegg on July 28, 2004, at 19:31:30
I want to thank you for posting your experiences as well. Wow, you are really doing deep, hard work. I'm thinking someday I might try analysis, too, assuming I can afford it. Although there is a Psychoanalytic Institute here, so I might be able to great a price break from a trainee.
Anyway, I wanted to say that some of what you wrote really ressonated with me. That intense well of pain...it's hard to believe sometimes that there can be so much pain there when you appear to others to be high functioning and having it all together.
I know now I grew up in an environment of emotional neglect. My parents has their own stuff going on and were very focused on their own lives. Being highly sensitive, I think this void affected me greatly. Such that during my therapy over the last year, I have regressed. It's been poignant, and at times fun. But hard to talk to others about. They think I'm weird for wanting to jump in the fall leaves just to hear the sounds of the crunch and smell the smells.
So thank you for sharing yourself with us. I wish you continued good work in your analysis.
Take care,
gg
Posted by Shadowplayers721 on July 28, 2004, at 21:56:09
In reply to Re: Being treated for a dissociative disorder » Shadowplayers721, posted by Pfinstegg on July 28, 2004, at 19:31:30
I have said the same thing over and over in t and at home about "losing it". The not being able to write is a HUGE problem. I can type, but hardly write. I never could in college write a paper. I could type one in a flash. It was like it by passed a function. Reading is another HUGE problem. I read something, but where does it go. In college, I read something 3-5X and still didn't know if it would come back in one piece mentally.
I can't say that I was ever high functioning. I always had problems. However, now, people are really noticing it. I can't always control how my voice will say things. Use to it would be more discrete. Not now. I feel like I fell apart. I thought I had a break down.
Yep, I had t's in the past say that I looked together with the exception of the shaking. I went to a doc today for a test and I felt like I wasn't really there. I don't mean spacing out. It was weird. It was like I wasn't paying attention to what he was saying. He kept trying to get my attention. Later, I thought what was that all about. I can't always predict how will respond to things. I do feel like I have open a closet door jammed full of toys and I can't jam them back in anymore.
The voices are louder and the names are constantly jumping out in my mind.
Posted by Pfinstegg on July 28, 2004, at 22:10:07
In reply to Re: Being treated for a dissociative disorder, posted by gardenergirl on July 28, 2004, at 21:30:35
Thank you for your encouraging reply- I really appreciate it. I've read that some psychiatrists think that neglect, as happened to you, is even more painful to endure than abuse, and I feel it could be true. Having previously tried twice-weekly psychotherapy, which was not helpful for me, I chose analysis- it was recommended by several therapists whom I went to for consultation. And I was directed to one who knew a lot about dissociation, because I had such a bad history. Contemporary analysis is extremely interactive and intimate- even more than the psychotherapy I had, which also was. Right now it's very painful, but, in looking head, I can see that it could become a joyful and fulfilling experience later on. My analyst is a training and supervising one, and I occasionally hear a bit about analysts in training. They already know an awful lot, so I think going to a candidate can be very worthwhile- and the cost is apparently very flexible, as the Institutes cover the costs. I think, for those who really need it, it's the best treatment available. The down-side, of course, is the cost, but, even more, the huge amount of energy and focus that it takes to go in every day. Still, as one who really does need it, I'm so grateful that it exists!
Posted by Pfinstegg on July 28, 2004, at 22:25:56
In reply to Re: Being treated for a dissociative disorder, posted by Shadowplayers721 on July 28, 2004, at 21:56:09
Oh, it does sound like everything is really pouring out just now. Do you see your T. often?
Posted by Shadowplayers721 on July 28, 2004, at 22:29:46
In reply to Re: Being treated for a dissociative disorder » Shadowplayers721, posted by Pfinstegg on July 28, 2004, at 22:25:56
Usually, I see her 2x/wk. Early in tx for trauma, I was flooded with memories. Now, I am flooded with these dysfunctions and memories. Very scary. I have been trying to distract myself with various things.
Posted by gardenergirl on July 28, 2004, at 22:30:56
In reply to Re: Being treated for a dissociative disorder, posted by Shadowplayers721 on July 28, 2004, at 22:29:46
Take gentle care, shadows. I wish you peaceful times and love.
gg
Posted by Pfinstegg on July 28, 2004, at 22:49:39
In reply to Re: Being treated for a dissociative disorder, posted by Shadowplayers721 on July 28, 2004, at 22:29:46
I am so sorry things are so hard right now. Does your therapist take care to speak to the separate parts of you? And is it possible to go more often when you feel that you are in a crisis? From my experience, it is probably a sign of progress that the different parts are pressing to the surface more. But it is really terrifying and confusing to go through, and I do think that when you are going through it, you need as much contact and support from your therapist as you can possibly get. None of us wants to repress or push down our different parts once more, when we have been working so hard to understand them and give them a voice.
Posted by Shadowplayers721 on July 28, 2004, at 23:18:09
In reply to Re: Being treated for a dissociative disorder » Shadowplayers721, posted by Pfinstegg on July 28, 2004, at 22:49:39
Thank you GG
Pfinstegg-There seems like a big conflict of knowing the outsiders or them getting to really know me. The t has actually drawn pictures of the faces she sees in t. She sees it and hears it, but I am not 100% still wanting to deal with it. It's hard to explain. It's an internal conflict.
Posted by Pfinstegg on July 28, 2004, at 23:28:19
In reply to Re: Being treated for a dissociative disorder, posted by Shadowplayers721 on July 28, 2004, at 23:18:09
I understand. This isn't something you can rush or just decide to do.
Posted by daisym on July 29, 2004, at 1:19:46
In reply to Being treated for a dissociative disorder, posted by Pfinstegg on July 28, 2004, at 18:16:49
We've talked about this before...I am very much doing what you are doing. I have a very young side, a 12 year old and then there is "me"...The very young side gives me real trouble because she is getting very strong and insistent in her need for "our" therapist. He responds to her very gently and so far has made it easy for her to talk directly to him. The 12 year old is still blaming herself for what happened, especially since she recently completed a memory puzzle that made it clear that the sa was intentional and brutal sometimes...not always "loving" and certainly not an "accident." She is doing most of the writing exercises these days. She writes in a powerful way about her belief in being bad and she is desperate to understand why she kept the secret when she was old enough to know better. Recent writing have led us to discover that she was afraid her dad would go to jail or to hell...or both. So imagine how I handled a discussion today that I was asked to step in a facilitate. Part of the training is for home visitors who are mandated reporters. So they watch a video of "child-abuse" and a report made and the cops come and take away THE CHILD. My fears were that they would take away my dad...The twelve year old freaked out -- The adult remained stoically calm and led the discussion.
By the time my Therapist called this afternoon, the "kids" were put away. I told him what happened and then went on to tell him how disappointed in myself I was that I didn't do as good a job as I usually do. And, that I struggled as much as I did. So we talked about Winnicott's theory of "good enough" and he is asking me to accept that the work we are doing is hard and very emotional. That most people would be having a tough time and that I should try to be OK with "good enough." Which led to a further discussion of my mother's expectations of striving for perfection. Even if you didn't optain in. She never got upset at me for not being perfect, she only got upset if I didn't TRY to be perfect.
I am always surprised by how deep we can go, even on the phone. I guess that speaks to the level of connection we've manage to develop, even among all my fears of attachment. And, he does relate lightly to the adult too...I shared that I started the training with my skirt unzipped...he laughed with me. I should have stopped before I started. It was an omen!
I'm going in tomorrow. My younger self is tantruming about being away all week. He asked her on the phone is she missed him. She said yes. He said he was sad she missed her session too...It is scary how quickly she comes out now when he talks gently to her. He told me not to worry so much, he was pretty sure that the big, bad gatekeeper would show up here again soon and give him hell. He notes that this part of me isn't going down without a fight to the death. And we talked about how slow this process is. He reminded me that it is ME who runs from therapy but he also said he thinks the pacing is fine. Pushing any harder was likely to send me over the edge and into crisis again. He did ask me to think about how I might participate more in the process instead of struggling against it so much. I told him I thought I WAS participating...I let him call me didn't I??!! He laughed and said it was definately a step in the right direction.
Ok, so I wrote more than I intended. I'm just glad to be home and even though it's late, I can't sleep yet. Thanks again for sharing.
Oh, I have a question! When your "little kids" get upset and cry and turn away, what does your therapist do? Does he allow silence?
Posted by Pfinstegg on July 29, 2004, at 7:28:11
In reply to Re: Being treated for a dissociative disorder » Pfinstegg, posted by daisym on July 29, 2004, at 1:19:46
Good to hear from you, Daisy. I think it's wonderful that you led those groups while you are in the middle of your own private, powerful emotional struggle. Even if you didn't do your absolute best, it sounds like you certainly did fine. It's funny about the zipper, too- something a bit light-hearted to share.
I knew that yur therapist thought the way mine does; I always love reading your posts, as they are fascinating, as well as very helpful to me. I think it's wonderful how flexible and available he is, and a real accomplishment to be able to continue the work by phone. I've never done that, and don't think it's something my T. does.
Hoever, in the phase of the work we've entered now, I see him EVERY day. This allows us to go to much deeper levels, and to keep them out there until the next time. It's very exhausting (not tio mention expensive), but seems so worth it- probably the only way for someone like me to dare to open up this much.
As to your question- the times of turning away to the wall are quite brief- a few minutes at most. He is not silent then; he very gently asks what happened just then to make the little girl, or the older one turn away and start to sob. He often asks which one is feeling so awful. In a few moments or minutes. *we* are talking again. I like very much how much he talks- interacts with the various parts of me. That helps so much.
Posted by Shadowplayers721 on July 29, 2004, at 7:36:09
In reply to Re: Being treated for a dissociative disorder » Pfinstegg, posted by daisym on July 29, 2004, at 1:19:46
Daisy,
I am like the circus. I am constantly changing. I admire you and Pfinstegg. Your insiders are more trusting in a way, because they are becoming more known. Mine play games, tricks, and clever riddles. I have felt someone listen in literally like a speaker phone. So, I will be crying and not know where the feelings are actually coming from. Sometimes, I will begin laughing and don't know why either. I tell the t this feels insane. So, I am rapidly *switching* as they call it. I never like that term.
My t never has treated anyone with DID before. She was taught that this was extremely rare. She said that she thought she was seeing things when she was seeing these faces come forward.
Yes, I know what you are talking about with the perfection issue. My mother & father had it. My mother even tells me to watch abuse incest programs. I tell her I don't need to, because I am handling as best as I can. There is no right or wrong way. The feelings are your guide.
I feel that people do have parts of themselves the adult, child, etc. But, do yours go by different names? Do you have a religious one that has a Biblical name? Even in my senior year book, I have students hand written notes to one of the names. My mother remembers a child calling on the phone to speak to a girl by another name when I was 12. So, mine is a bit more weird I guess. I think it's normal to have an inner world of children. I think for healthier adults they don't cut off so much and the adult is still able to be feel all sides of themselves. I don't know.
I have physcial problems-shaking, extreme vertigo, headaches, vision changes, hearing changes, seeing things moving, and feeling things moving. One time, I had an ENT treat me for a year for what he thought was an inner ear problem. Nothing showed up. No one could figure out the baffling symptoms. I saw every type of doc imaginable. Finally, I felt this was a mental thing causing all this and decided to see a psych.
Posted by zenhussy on July 31, 2004, at 3:19:57
In reply to Re: Being treated for a dissociative disorder, posted by Shadowplayers721 on July 29, 2004, at 7:36:09
You all have my utmost respect for discussing this here. I'm sorry I'm not able to add my comments as this is something I've learned quite a bit about over the years and yet I still have questions. There are so few places in which to safely exchange information (imho) and this isn't one of them for me. I hope you understand.
I know how to get in touch with everyone but Pfinstegg but I'm sure if I wanted to convey some inquiries someone would be kind enough to pass them along if possible. tia
I am just honoured that you all write this here as you do. You are brave women. You are courageous in all your different approaches to this.
--zh
Posted by Pfinstegg on July 31, 2004, at 22:04:06
In reply to Re: Being treated for a dissociative disorder, posted by zenhussy on July 31, 2004, at 3:19:57
Thanks for your message, zenhussy. I understand that you might not feel safe discussing this topic here. I wouldn't have, a year ago, but now that I've become more aware of what's going on with me, and have gotten such wonderful help from my analyst, I felt like I wanted to be more open about it on PB. It's scary to think of having any degree of dissociation- and the people who have posted at various times have varying degrees of it- from private inner switches in ego states to more severe degrees of dissociation which others can observe. It's a hallmark of csa.
I especially wanted to write what I could about it here because I think it's a diagnosis that isn't made as often as it should be. I am very lucky to have a therapist who specializes in trauma and abuse, and who always looks beneath the anxiety and depression for dissociative ego states. I've been to other therapists who basically tried to strengthen my confidence in my adult abilities; this is the first one who has looked for, and related to, my cut-off child states. I was terrified of anyone doing this, but, as I have become able to allow it, and participate in it, the pain I have carried with me my whole life has diminished so much. I wanted everyone to know that, even years later, there is really effective treatment for childhood abuse, no matter what particular kind it is- emotional, physical or sexual, or all of them together. I am thrilled at how much better I feel, and I look forward to going to my analyst, every day for the time being, to keep allowing my *children* to speak to him more and more fully. I try to keep as careful a journal of it as I can, because, despite all the terror and pain, it's such a fascinating journey!
Posted by Aphrodite on August 1, 2004, at 16:01:52
In reply to Being treated for a dissociative disorder, posted by Pfinstegg on July 28, 2004, at 18:16:49
Your post really resonated with me. Thank you for sharing your moving and poignant story. Your T sounds wonderful. I am especially impressed with how he talks to your younger parts. I completely relate with your description of the children wanting to attach and immediately recoiling at the same time.
I've always had the different voices arguing in my head and heart, and so if one good thing has come from my therapy, it is that this makes sense to me now. I also do not have DID, but I am consciously aware of about 5 ego states that clammor for therapist's attention. Mostly there is the accomodating, functional, and diplomatic adult everyone knows as "Aphrodite," and there is a darker, cynical adult that speaks and thinks very much like my father. There is an isolated and withdrawing teenager who doesn't like conflict and wants to be alone after all the terrible things that happened to her. There is a younger, very wounded child who still has hope and optimism and who wants the interaction with my T the most. And the fifth is a very hidden authentic me, the person the cheerful child may have become if all the abuse and neglect did not get in the way. She is very silent.
I read a technique once in preparing for my EMDR sessions. It's imagining inviting all the different ego states to a conference table and hearing all the objections to therapy, to one another, and trying to reach a consensus. That image works well for me since I often facilitate meetings through in my work life. I can really visualize and "hear" all of these parts of me, and it's less like a million voices in the head -- it's much more organized.
The trick is getting the cynic on board who leaves every therapy session determined to quit.
Thanks for your post and the opportunity to discuss this. It's all so new to me.
Posted by daisym on August 1, 2004, at 19:05:28
In reply to Re: Being treated for a dissociative disorder, posted by zenhussy on July 31, 2004, at 3:19:57
Zen,
I'm sorry you don't feel safe here. Maybe I'm so much a pollyanna that I don't see potential hurts where I should. I just feel so much better knowing I'm not the only one having this kind of experience. No one I know irl has ever talked about anything like this. Not that I've ever shared it either...
I hope you are well and making progress.
D
Posted by daisym on August 1, 2004, at 19:09:31
In reply to Re: Being treated for a dissociative disorder » zenhussy, posted by Pfinstegg on July 31, 2004, at 22:04:06
I just want to echo that I find it fascinating and frightening as hell...simultaneously! I wish I could say I looked forward to going, but there is still a huge push/pull. My therapist discussed this as negative transference towards therapy as a whole. He meant that sometimes I blame therapy for my pain, instead of my experiences. So I think if I quit or cut back, I won't hurt. He points out that instead I'll just be alone with it all.
I hate when he is right. :(
Posted by daisym on August 1, 2004, at 19:14:14
In reply to ego states » Pfinstegg, posted by Aphrodite on August 1, 2004, at 16:01:52
Aphrodite,
Nice to see you venturing back a little...
I like the concept of a meeting. But my fear is that the gate-keeper would scare everyone else into silence again. It works better for me when my therapist sort of sneaks up and talks directly to the younger parts before she can edit. Of course, she does jump in as soon as she catches onto what is going on.
--D
Posted by Pfinstegg on August 1, 2004, at 22:30:32
In reply to ego states » Pfinstegg, posted by Aphrodite on August 1, 2004, at 16:01:52
Thanks so much for replying, Aphrodite. Even though I am finding my own therapy experiences with my dissociated parts to be so powerful- and so helpful-, I felt that maybe I was venturing too far into unknown territory in speaking so candidly about them here. So I do really appreciate the support from you and Daisy- I feel so reassured that i didn't cross over into too uncomfortable an area.
I think there are presently only three or four of us posting about ego state disorders (I think that's the correct term when you don't have DID, but have something less severe along the same spectrum). I put up a huge fight against recognizing that I had it (to the point that my T. said, "you're almost making ME doubt it, too!- not really- he was teasing) But, as the various parts began to emerge- often through slips of the tongue, or strange things that I couldn't believe I'd actually said- the whole process of therapy has gotten easier and begun to make much more sense. I don't really know what lies ahead- in terms of how integrated I'll be able to get, but just learning to give all the different parts a voice- and to try to respect and comfort them- has made me feel a lot better. Do you feel, as my T. and I do, that it is an under-diagnosed, and under-treated, disorder?
I'd love to know how EMDR fits into your therapy. It sounds like it's a real help. Is it supposed to help the unconscious parts of your different selves become more integrated with one another, or more available to your conscious awareness?
Posted by Aphrodite on August 2, 2004, at 13:10:12
In reply to Re: ego states » Aphrodite, posted by Pfinstegg on August 1, 2004, at 22:30:32
You know, my T hasn't said anything about it being underdiagnosed. In fact, he hasn't called it anything at all, so I'm glad to know your term for it -- "ego disorder." I'll ask him. I believe he thinks everyone has this to one degree or another; it's just that for us, some of our ego states have been traumatized.
As for EMDR, the visualization inherent in the process seems to be a way to build "ego bridges" that link the various parts of ourselves with the ultimate goal of integration. I find it very helpful. For instance, I have visualized a literal bridge in which the child part of me lead the adult by the hand across the bridge to the experiences and memories that I have suppressed.
Does that make any sense?
Posted by Aphrodite on August 2, 2004, at 13:11:11
In reply to Re: ego states, posted by Aphrodite on August 2, 2004, at 13:10:12
Posted by Pfinstegg on August 2, 2004, at 15:12:16
In reply to Re: ego states, posted by Aphrodite on August 2, 2004, at 13:10:12
Yes, thanks! It's very helpful to hear a bit more detail about EMDR. It's an unknown area to me, but my own T. sometimes uses it as an adjunct to his own therapy (he doesn't do it himself, but recommends to someone who specializes in it). I am considering it, and so want to learn all I can.
I think our Ts would be entirely in agreement about the ego states. He thinks, also, that everyone has different parts, but that in non-traumatized people, the parts are naturally more integrated. In Ego State Disorders, there start to be abnormal degrees of non-integration, with cut-off parts carrying the memories of trauma, neglect and abuse. We probably have the mildest degree of this, while people suffering from DID/MPD have the most severe. I really feel for them, as it must be SO hard to get started on the road to re-integration.
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