Scattered pieces

In an attempt to change some traditions and behaviours that occur at this time of the year due to anniversaries, we’re going to try something new – thanks to Amy for the idea.  Each day for the next month we’re going to take a random photo and put it up here.  Today we’re going to cheat a bit and use a photo we took awhile ago that some of us like.

Rain coming

Memory functionality in those with Dissociative Identity Disorder (DID) is probably one of the most controversial part of the diagnosis.   According to the DSM-IV-TR, in order to meet the diagnostic criteria for DID, a person must experience:

Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.

(American Psychological Association, 2000).

The wording for this criteria mean that it is up to the diagnosing professional what is to be considered “extensive”.

In our experience this has meant that a majority of our childhood cannot be remembered.  There are occasional snippets, but much of our childhood and teen years, up until the age of 16 are predominantly made up of family stories and certificates.  We get glimpses or snatches of our past, but much of it is a blur of pictures, smells or just is “lost”.  It’s a very odd feeling to have little knowledge of your own history.  What memories we do have of these years are lumped in the ages 7-9, this is not so much because these were the ages where we have clarity in our memory; but rather because the two alters who were most present in our younger years are this age.  Because they have little concept of time, everything happened to them and they are 7 and 8, so it must have happened to the body when it was 7 and 8.

This has confused many people assessing our mental health as we are able to mention lots of things that happened in those years.  What they often neglect to ask is about the school we were attending at the time, or whether we wore a school uniform to place the experience into a context.  So our 8 year old will say that “experience X” happened when we were 8.  But she also knows that we wore a school uniform at the time, meaning that it must have occurred after the body turned 13 as this was when we had to wear uniforms for school.

This concept raises the specter of False Memory Syndrome (FMS) and inaccuracies with recovered memories.  If we can’t remember most of our past, how can we be sure that any abuse we talk about happened?

In What is DID? I mentioned the opinion that DID is on the Post Traumatic Stress Disorder (PTSD) continuum.  Note that the major aspects of PTSD are re-experiencing the event and avoidance of the stimuli; with amnesia considered one possible way to avoid the stimuli.  According to Leskin, Kaloupek, and Keane (as cited in Gleaves & Williams, 2005), there is a struggle between re-experiencing and avoidance.  But it does show that it is possible to experience amnesia for traumatic events – for example in documented events such as the Holocaust (van der Hart & Brom, 1999).

An important distinction in this amnesia is that while the autobiographical memory might be affected by the trauma; the feelings, habits and sensory memories will remain (Gleaves & Williams, 2005).  Again, to bring this to our experience, one of our triggers is the smell of rubber.  We would avoid the smell of rubber without any realisation as to why.  We knew something bad had happened in a school playground, and it was only when more of the autobiographical memory was accessed that we realised that we linked the smell of the rubber to the tractor tyres that we were on.  So from this event our sensory memory remained intact, but the autobiographical memory was partially lost.

So if DID is further along the PTSD spectrum, surely this would mean that the memory issues surrounding events would be more advanced.  Whether this advancement would also impact on the sensory memory is not clear – again in our case, we have some sensory triggers which we cannot tie to any event.  So it would seem as if there are more gaps in autobiographical memories as the trauma covers more events over a long period of time.

So is this recovered memory accurate?  Studies cited in Gleaves & Williams (2005), state that the central themes of recovered memories are no more or less accurate than continuous memories of abuse.  In the instance that is described above, one of the perpetrators was jailed two years ago for historical sexual abuse to other girls – so women independent of us reported this man as being an child abuser while he was in his early to mid teens.  We could have all imagined it, but the chances of this same man being nominated as a random target by women with no contact with each other would be fairly long odds.

The other controversy associated with FMS is that DID is an iatrogenic occurance cause by over zealous therapists.  In some respects this controversy has had the benefit of causing a growing number of studies which look at the DID diagnosis from a variety of viewpoints.  Gleaves & Williams (2005), accept that poor therapy techniques can cause someone with DID to deteriorate, but this is not iatrogenesis.  It indicates that there needs to be training for the therapists in the areas of healing from trauma.

I’ll expand on some of these ideas later in another posting on DID and time loss and co-consciousness.

References

American Psychological Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR (4th ed.). Washington: Author.

Gleaves, D., & Williams, T. (2005). Critical questions: Trauma, memory, and dissociation. Psychiatric Annals, 35(8), 648-654. Retrieved January 11, 2009, from Health Source: Nursing/Academic Edition database.

van der Hart, O., & Brom, D. (1999). When the victim forgets: Trauma-induced amnesia and its assessment in Holocaust Survivors. In A. Shalev, R. Yehuda, & A. McFarlane (Eds.), International handbook of human response to trauma (pp. 233-248). New York: Plenum Press. Retrieved January 13, 2009 from http://www.onnovdhart.nl/articles/Whenthevictimforgets280405.pdf

Last month we signed up for a calling plan that would save us money on our toll calls.  Due to a couple of mis-understandings between us and our toll provider we were facing a rather large phone bill for the December period -  causing more than just a bit of panic.

In an attempt to sort it out, M sent a couple of polite and then a couple of more blunt emails to the customer service department.  The end result is that she got about $200 refunded on the telephone bill.

However, in the meantime C rang the toll provider and talked to another part of their customer service team.  She explained the situation and mentioned things along the lines of wanting to talk to supervisors etc.  The end result is that she got about $80 refunded on the telephone bill.

So from a bill that was looking at being about twice what we usually pay, we’ve gone down to paying about $60 less than usual :)

Neither M nor C knew that they were both trying to sort out the same mess – M is more comfortable communicating via email, and C prefers the telephone (so that the other person can feel the lashes of her rather sarcastic tone).  End result – we’re better off financially.

If only all the time loss and memory issues could be this financially beneficial and amusing – well it was amusing for me as I knew what both of them were doing.  My excuse for not stopping one of them is I wanted to see if either of them were successful – and OK the sheer fun of watching them was pretty good too.

We went to a Mindfulness Based Stress Reduction course a few years ago after being recommended it by our therapist at the time (who also ran the course – hmmm conflict of interest BIG TIME).  So we went obediently along hoping that it would help us be more “present” and slow the dissociative process.  There was a small group of about 10 people and they were quite an eclectic group – school counselors, couple with Parkinson’s Disease, some with anxiety and some with abuse issues.  First off we don’t do well in group settings – have this tendency to clam up unless Sophie can be present and shyly chat with a few other introverts.  So our experience with the whole course was not all that good.  It ended with a day of silent meditation and reflection – otherwise known as triggering hell.

During this course, we were read this poem/short story called Autobiography in Five Short Chapters by Portia Nelson.  Initially we thought that it sort of explained our life – remember we’re hearing impaired and that this was in a group setting where there were influences of the others going “ohhhhh yes, that’s our life”.  Ok, so some of us thought it was therapy dribble that didn’t deserve the time taken to read it – but some of us thought it made sense.  We recently read it again and, possibly with a more cynical eye, wonder about the real message it is sending.  The first two chapters say “It isn’t my fault” and then move onto “It is my fault”.  I’m not sure about anyone else who’s been through abuse, but we ALWAYS blamed ourselves or each other for the abuse from the start.  The hard bit is trying to feel any anger (or anything) towards the abusers.  Surely we asked or deserved to be treated like that, why else would anyone do those things?

There’s an analysis of the poem at another site that talks about the metaphors etc.  But now we question it’s appropriateness for abuse survivors and wonder if it should have been read at the Mindfulness course at all – or maybe it was an indication of the worth/quality of the course???

I was going to try and alter the poem to look at it from an abusive point of view, but can’t.  We aren’t wordsmiths, and the poem just doesn’t suit our experiences.

We’ve just realised we have NO idea how to end relationships of any kind – but in particular any professional relationship.  Whenever we’ve resigned from a job, stopped seeing a doctor and so on – we panic.  The first time this was abundantly obvious was when we left the garden centre job we had after finishing our undergraduate degree.  There were probably more earlier than this, but I have no awareness of it.  All we had to do was hand in our resignation letter, but we put it off for over a week and jeopardised our notice period.  We had a good excuse for leaving – we were going back to university.  I have a sneaking suspicion it was just an excuse and not the real reason for moving on.

This is potentially part of the reason why we kept within the relationship with the husband so long – but it would have been level pegging with us being a “typical battered wife” (don’t you just love that label).

But what is odd is that we find it harder to end the professional relationships than we do the personal relationships.  I wonder if it’s to do with the fierce sense some of us have to be working in order to be invisible?  We were unemployed while we studied via distance learning when we started our undergraduate degree and we had to go through job placement interviews with government agencies as part of their attempt to get the unemployed back into work.  We found that incredibly stressful.  This is also possibly part of the reason why we have resisted going onto any form of disability which we qualify for with room to spare.  Anything to stay invisible.

We’ve never stayed in one job for any length of time, up until the marriage when part of us realised we needed more stability in one aspect of our life.

All of this leads in a rather convoluted way to why we’re finding it hard to stop seeing the clinical psychologist and move on.  We had therapy today and told her that while integration is potentially an end goal, there need to be smaller goals that lead up to it – like developing more communication internally to reduce the time loss.  It looked like it was all going well with her understanding and agreeing with us.  Then I’m not sure if we were misinterpreting her, but it appeared like she was playing word games again by saying things about staying the same was safer and that we knew so many coping strategies as it was that there seemed little use in developing more.  We asked how it was safe to continue living as we were considering that being sectioned wasn’t all that safe, neither was the suicidal ideation.

We’re not sure if she’s playing games, we’re being too sensitive or whether we just need to bug outta there.  Cos you know, life living with dissociation just ain’t hard enough by itself, we thought we’d throw in some other complications as well just for fun.

Recently we’ve been having “issues” with our current therapist.  As part of trying to find a new therapist, we contacted one in our home town who is listed on the ISST-D site.  With no real idea who we were or our background, she took time out of her day to recommend another therapist closer to where we currently live to see if she knew of anyone.

We contacted the therapist closer to us, and again she took time out of her day to ask if we could travel to Auckland (where there are a few therapists with experience in helping those with dissociation) and saying she’d get back to us.  Those who have read of our adventures about travelling to Auckland for a conference will know this isn’t really a possibility. Today we heard back from her, she apologised for not getting back to us sooner as she’d been on holiday – good grief we were just thrilled she replied at all!  She’s given us two people to try – both are registered with ACC so we can see them at reduced rates.  One is the supervisor of our previous therapist (who is nice, but just doesn’t have the skills to cope with the dissociation); so we’re going to try the other therapist first to see if she is taking on any new clients.

Thank you to all the therapists out there that go above and beyond to help a total stranger in need.  We’ve been stunned with the assistance that we’ve received and are grateful.  Some would say “that is their job” – but for helping us there was no financial reward, it was purely working from an ethical and moral standpoint of helping someone in need.

So a big Thank You to the therapists out there!  Yes, some should be on the other end of the therapy relationship, but some are excellent and help restore/maintain faith and belief in the profession.

Ok… so we’re not that good at taking photos.  We just can’t get out of technical and perfectionist mode.  But last night there was the most beautiful sunset and here’s our attempt at trying to capture it…

Red sunset over Hamilton

Sunset through the cabbage tree

Hope you all have a good day :)

Take care… Sophie :)

Tonight we showed the mother a clip we did to show the different parts we know of that make up our dissociative system…  We were terrified about what her reaction would be, but she just watched it and then gave us a hug!  She then asked questions which didn’t hurt or demean us…

She doesn’t understand it, but wants to know how people around us can help…

Tonight she admitted that there was psychological abuse in the house when we were growing up!!!  She has never admitted to any form of abuse occurring before.

WOW…  We’re stunned…

It’s going to take awhile to process it all…