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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by alexandra_k on August 24, 2004, at 21:00:30
Hello to everyone who remembers me (and even those who don't). I haven't written anything on the boards since around February, but I do have a look from time to time. I would like to thank everyone who answered my posts, and I would like to thank you all for posting your own stuff. You all really helped me keep on going when I was feeling really alone and afraid without any support for my mental health stuff. And hearing what was going on for other people in the world helped prevent me from becoming completely absorbed by myself and my despair.
Therapy has just gotten to the point where decisions need to be made. Well, its always a bit like that, but there is a bit of a crisis. I have been diagnosed with BPD and did the DBT thing for a year, but this has not assisted me with the problems that concern me the most. I hear voices and miss time, and find that I've done stuff that I don't approve of (such as self-harm, high risk behaviours, drug use etc). This has been treated with medication but the medication has not really had an impact on these issues. Recently my therapist informed me that she had received emails from the voices, sometimes angry and attacking emails but that she felt it best to just ignore them. She passed the emails on to me and they mostly consist of attempts to communicate with her, and attacks at her non-response. My concern is that my psychiatrist is looking at a diagnosis of DID (if my EEG comes back clear for temporal lobe epilepsy) but that here CBT is the only publicly funded treatment and to the best of my T's knowledge the only 'treatment option' is for me to basically be punished for the behaviours which lead to that diagnosis. I have said that I am not a fan of the approach where the T tries to summon them forth etc and as I have some form of communication with them already (in the form of voices), why can't we work on improving communications between me and the alters (which should be the priority anyway, rather than her getting to communicate with them). Anyway, she hemmed and hawed and now she says she needs to take it to her supervisor because she cannot deliver treatment that is not empirically supported or that is not acceptable to the service.
Does anyone know of a treatment manual (I realise there are an awful lot out there)- or even an article would do - that is written by a reputable author from within a CBT framework? All I have encountered is Spanos socio-cognitive model which involves punishment for the behaiviours which lead to diagnosis. Any help gratefully recieved, thanks.
Posted by Dinah on August 25, 2004, at 9:40:34
In reply to thanks everyone... and request for info, posted by alexandra_k on August 24, 2004, at 21:00:30
I'm afraid I can't be of any concrete use. I'm sure you've done the usual internet searches. :(
I just wanted to say that I'm sorry, though. I can't imagine how they think behavioral modifcation therapy is useful to something that is only partially behavioral. Sure, if you punish parts of yourself for trying to communicate, they might stop trying to communicate. But what does that mean other than that they stop trying to communicate? It doesn't change anything else at all, and it astonishes me past belief that anyone would make the logical fallacy of thinking if behavior modification stops alters from showing themselves to a therapist, that means that there where no alters to begin with when it is just as likely that all it means is that the alters are going to hide from the therapist. With research designs that are based on such shaky assumptions, research becomes useless. It's not even true behavior modification, as the alters can continue to show themselves outside therapy. It's merely behavior modification within therapy whose only possible benefit is to the therapist.
With my own ego states, my therapist didn't seem too keen on them when I first brought them up. I had to talk around them for *years* to fit in with what I thought he wanted. It didn't change my internal structure, it just changed my external behaviors around *him*, and hindered the progress of therapy. :(
Posted by alexandra_k on August 25, 2004, at 17:48:16
In reply to Re: thanks everyone... and request for info, posted by Dinah on August 25, 2004, at 9:40:34
Thanks Dinah :-) Yup, I've done internet and database searches for articles, but treatment manuals get by article searches. Haven't really looked for books because they are expensive and harder to get hold of. Read Colin Ross', but was a bit too 'out there' for me with respect to eliciting alters.
I agree with you on the old behavioural modification approach. Maybe I presented it in a harsher light than its advocates would approve of, but I have to say that that is how it struck me.
My T is having a meeting with her supervisor today to figure out what to do with me (fingers crossed, wish me luck). I'll find out next week sometime. I understand what you mean about having to talk around them all the time and how that hinders the progress of therapy. I can't do behavioural analyses for behaviours I don't remember doing, and I have no idea why on earth they do them. But I can't express this in a non-DID way, and T's think I am purposely obstructing the process of therapy AAARGH.
I am interested in how things are going with you. Are you working with someone on these issues? How is that working out for you?
Posted by Dinah on August 25, 2004, at 19:06:42
In reply to Re: thanks everyone... and request for info, posted by alexandra_k on August 25, 2004, at 17:48:16
I've ordered a few books, and I must regretfully say that the only people who scare me more than the ego state detractors are ego state proponents. :( I don't know of any I would actually recommend. I liked "The Myth of Sanity" by Stout and "The Stranger in the Mirror" by Steinberg, but neither had much in the way of a treatment plan.
Fortunately, I don't have any amnesia so I don't have any of those issues to work around. It must be much more difficult when you do have associated amnesia. :(
I think a fair amount of my work on this subject is done. I have a reasonably good understanding of what is going on, and don't really agonize over it any more. The only thing that I really still grapple with is the shame that I unfortunately feel about it, not the actual experience.
But my case was far less complicated as I had no amnesia, no serious abuse in my past, etc. The main thing I needed was someone who accepted me as I was, and helped me figure things out in a matter of fact way. And I now *accept* it, more or less. I just feel shame because of public perception, which I project inwards.
This is the end of the thread.
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