Mental Health Warning Signs: Note from the Bottom of a Cliff
Remember when I said I didn't know what to do about mental health warning signs when they flare up? The past two weeks of my life painfully demonstrate the consequences of that ignorance, along with some of the ugly truths about dissociative identity disorder. I knew my mental health was deteriorating. I was talking about it, writing about it, and actively looking for solutions. I saw the edge of the cliff and did everything I could not to fall. But fall I did.
Life at the Bottom of the Cliff
I believe I'm lucky to have dissociative identity disorder at times like this. I've no doubt people with other mental illnesses live at the bottoms of cliffs sometimes too. And I suspect it's more painful for them. After all, they don't have dissociation to soften the blow. As for me, falling means:
- Losing time. I live with dissociative amnesia to what is technically a severe degree every day of my life, but the more unwell I am, the more time I lose. And I simply can't account for much of the last few weeks.
- Getting physically sick. I rarely get sick. But when my mental health is deteriorating I'm more vulnerable to illness and these past few weeks have been no exception. (I'm much better now, thanks to antibiotics and lots of rest.)
- Exhaustion. It seems like people should slow to a stop, doesn't it? But I don't realize how low I am on fuel until I'm completely empty. One day I'm barreling along at 70mph and the next I drop like a sack of potatoes. My partner says she found me sitting on the stairs one morning this week, too tired to keep heading down.
I could go on, but I suspect those are fairly common hallmarks of decompensation for those with dissociative identity disorder. Severe fragmentation can keep you going despite overwhelming pain or stress, but that's only an asset in times of genuine crisis. In everyday life, when the stakes just aren't as high as they seem, it's a liability. Bottom line: dissociation costs, and eventually the bill always comes due.
Climbing My Way Back Up
For me, paying off that debt requires a good deal of rest, solitude, and quiet. Creative expression at times like these is incredibly soothing, so I try to draw, paint, collage - whatever I can with the tools I have. I listen to music and try not to feel too guilty about dropping off the face of the earth. And, quite frankly, I'm extremely fortunate that I can do all that.
Not everyone with Dissociative identity disorder, or any mental illness for that matter, has the love and support that I do. Today I took this picture of flowers my sister sent me so I could share them with you - you who may be careening off a cliff, or writhing at the bottom, without a loving sister to send you flowers when you most need some beauty. I'm with you in spirit, for whatever it's worth.
Until Monday ....
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APA Reference
Gray, H.
(2011, February 8). Mental Health Warning Signs: Note from the Bottom of a Cliff, HealthyPlace. Retrieved
on 2024, November 24 from https://www.healthyplace.com/blogs/dissociativeliving/2011/02/a-note-from-the-bottom-of-the-cliff
Author: Holly Gray
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Holly, although I have never met you in person, I feel I have a common bond with you and I find myself drawn to you and your experiences. I am concerned about you and your relapse (if you will). I am glad that you have a strong support group. Something I wish I could have. Instead my life has to remain a secret and I cannot share or release my fears or feelings. I feel You have a much better chance at feeling good again by releasing it. Your roses are Beautiful. Looks like your sister got you 3 dozen? She loves you very much. May I ask you a question? Does it help you to be able to write your experiences and feelings? Does it help you to get it all out of your head so you can continue moving forward? Does writing it down help to delete some of it from your memory banks and ease the memory load somehow? My hopes for myself is to be able to do just that some day. I will continue to check in with you from time to time to make sure you are doing well. I send you thoughts and hopes for a continued healing, my new friend. Patti (Paula)
Hi Patti,
So nice to hear from you. :) I want to reassure you first that I am coming out of my relapse and doing what needs to be done to take care of myself. I'll be okay. You're right that the support makes a huge difference. And I'm really glad you asked about writing ... Patti it really is so helpful. And it's also a form of support in it's own way. People like you comment and say how much they relate to something I've shared and that is truly healing. It reminds me that I'm not alone and that though our experiences are each unique, I am not isolated and cut off. I want that for you too. And you express yourself so well. I believe you can write your story. It may seem overwhelming, but if you take it in small chunks (perhaps by starting a blog) it might be easier than you think.
I will say that writing things down doesn't delete it from the memory banks. In some ways, it helps to bring things forward more strongly. But at the same time, it takes the sting out, so to speak. Sharing my experiences has done wonders for me in that way - it brings things down in size and scope, if that makes sense, allowing me to feel less controlled by the past. Have you ever read There's a Nightmare in My Closet, by Mercer Mayer? It's a children's book and by mentioning it I don't mean to trivialize your experiences by comparing them to a child's story - no, you have a genuine nightmare in your closet. What I love about the book is the metaphor - that by drawing the monster out, facing the nightmare, we take our power back. It's a painful process, but it's incredibly healing.
My wish for you is release from the strangle-hold your nightmare has over you. Please do check in from time to time. I would love to hear from you, friend.
Thank you all for responding.
Laurie, it seems we have similar experiences with this issue. I will consider talking with her about it.
I didn't mean to take this thead in a different direction.
Hi Holly, I've been thinking about your recent bad patch a lot, but because I've been going through one of my own, I haven't been able to string my thoughts together well enough to respond with any insight. But now that I'm coming out the end of my tunnel, I'd like to commend you for having the courage to write about yours. Hearing someone else be up front about the times when they are down and desperate, makes it easier for the rest of us to do the same. And what a huge relief it is to have a safe place to do so, namely your blog site. May every time we sink to the bottom of the ocean be shallower than the last, until we reach a point where we can finally float around in peace.
Hi kerri,
You've been in a bad patch too, eh? Exhausting, isn't it? I find that recuperating takes a frustratingly long time. It's a slow process rather than a brush-yourself-off-and-get-back-to-life kind of thing. I'd much rather bounce back, but it never seems to work that way.
"May every time we sink to the bottom of the ocean be shallower than the last, until we reach a point where we can finally float around in peace."
Love the imagery and the sentiment.
Thanks, kerri. I don't feel very courageous at the moment, so this was particularly nice to read. :)
Lenore,
I wanted to respond directly to your issues. I've been there and I'm surprised to realize I'm becoming, for the first time, more settled with them just recently. It was a long hard battle. Don't be afraid to tell the therapist what you are struggling with. I felt that the confusion about the paid relationship significantly affected whether or not I was ever going to be able to trust this woman. I also knew that one day our relationship would end. I read a lot and finally - after some prompting - began to talk with the therapist about them. If you've been through it and I've been through it, others have been through it. All we can do is trust that our therapists have enough experience to guide us through that. If you get anything but understanding from your therapist, be concerned. They are your feelings and the two of you need to work them out. Once you've learned to do it with her you'll be better able to talk about your feelings with other people. You'll be able to have relationships.
The statement about she's offered to take calls but I'd never ask for help - in fact I continue to struggle with asking for help - from anyone! It seems I devalue my needs and have grown up believing I was a bother and a pain in the neck - nothing but an inconvenience, trouble. I can't ask for help - it was never forthcoming and it always got me in trouble when I asked for it. I'm slowly learning to ask for it but I'm not there yet. It occurred to me this week that when others contact me - say when they are away - I appreciate the contact. I don't give them the same opportunity to appreciate that I was thinking about them.
I just want you to know that what you are struggling with is "normal" from my experience. Persist. Get some information about attachment and DID and or ask the therapist to see if she has anything that might help with respect to attachment and DID. Once you understand the attachment issues it might make it easier for you to walk through your confusion with the relationship.
Hope this helps.
Laurie
Holly, Lenore, Anon,
I think I hear what you are saying about your relationships with your therapists. I believe I've had all the same struggles and same approaches to my therapist at the various stages of my therapy. The therapeutic relationship has been the most difficult part of my healing to manage. I'm very good at thinking about the relationship, so I can ask for help coping with various issues - I call it intellectualizing - have always done that well. What I've never found easy - with anyone - is relating. How do you relate to someone if you don't let them in? My struggle was letting the therapist - or anyone including my family - in. So we are working on that.
Maybe I'm just at a different place or space in my treatment. What I do know is since I've started breaking down the wall - the lack of trust wall - my day to day function has increased and my confusion about the therapeutic relationship has improved. I've treated the therapeutic relationship the way you all describe - maybe I'm just working on different things now so the focus has changed.
I think the treatment of DID is evolving all the time, a review of the literature clearly illustrates that. As Holly says, whatever works. I keep looking for the magic bullet - right now, the therapeutic relationship, as it mirrors my issues with relationships, seems to be the key to my recovery. I'm not sure I'd have understood the significance of my therapeutic relationship a year ago.
Keep doing what's working, if it's not working find something that does work but don't be surprised if you struggle with your therapeutic relationship - it's part of the process.
Take care of yourselves.
Laurie
Hi Laurie,
I think it's true that where we are on our healing journey makes a difference in how we approach therapy, and our needs in the therapeutic relationship. But it's primarily just a simple matter of style. There are a number of different treatment models and what works beautifully for me may be damaging to someone else, and vice versa. No matter what you or I or anyone else may think about someone else's therapeutic choices, there really is no right way to "do therapy." It's a matter of finding the best fit ... and that has less to do with where we are on our paths or how much progress we've made than it does with who we are as people. The keys to recovery are not the same for everyone.
I think it's awesome that you know and appreciate how vital the therapeutic relationship is for you. Figuring out what works and what doesn't can be hard sometimes. It's great that you have a solid sense of what works for you right now.
Which reminds me of something I heard from a highly respected clinician in the field of trauma and dissociation, "You have the capacity to judge for yourself what's working and what's not." Some of the best advice I've ever received.
I feel similarly to Holly about the professional nature of the therapy relationship. Thanks y' all for the discussion, it's fascinating to hear how different therapists can be...
It helps me if I stay focussed on very concrete goals when interacting with my psychologist. She initially helped me enormously just by explaining what the hell was happening to me, what dissociation is and about how anxiety colours experiences. Sometimes I go in and just ask something like, "I want to be able to walk to the shops without dissociating and getting myself lost and all upset, what can I do?" A few times I've wanted help coping with/managing voices in my head. Of course tackling these things sometimes goes over a few sessions and involves medication adjustments; I'll try a few strategies, we review them, try something different, try to work out what helps. Sometimes she counsels me through more abstract upsetting things like "who the hell am I really?" or "why should I live if I have to suffer like this?" or the embarrassment and shame I feel about my differences. Sometimes she helps me work out life stuff like study plans, food and meal planning, work, and relationships with others. On occassions she has acted as my advocate, phoning social services and other health professionals on my behalf. But I never feel that she is anything close to a partner or bff or parent.
I know I'm getting too close to/dependent on the psych when I start to narrativise everything that happens in my day, as though getting it ready to tell her. I really hate that feeling. Then I have a break from seeing her for a few weeks and try to break that habit.
It's not perfect, I'm not cured and I don't really expect to be, and that sucks. But it's generally working for me, I'm more and more "functional" (I hate that word though), improving my present and trying to make a future, one piece at a time.
Hi anon,
I relate to your approach.
I expect my therapist to become unnecessary one day, rather than becoming more and more vital to my ability to heal and recover. Some detractors of Dissociative Identity Disorder have pointed to over-dependence on therapists as evidence of what they see as a therapist-created phenomenon and the deteriorating ramifications of that. And quite frankly, they have a solid point. Though I (obviously) believe DID is a genuine mental health condition, I agree with those detractors in that treatment should empower clients, not make them more and more helpless as time goes by.
That's worst case scenario though, and not what anyone in this thread is proposing. I bring it up to shed light on why I eschew attachment driven therapy, even within more reasonable limits. It sounds like, for you too, living your own independent life is a priority for you and that while you value the help you receive in therapy, you use that help to fuel your own growth as an individual away from the therapy couch. Yeah, I definitely relate to that.
Laurie
Thanks for your reply.
I seem to have a pattern of developing a trust w/ my therapist, start to open up & then realize I'm feeling to attached to her & getting way to close, so everything shuts down inside & we move back to step 1 all over again. She has no problem with attachment & I believe she sees it as par for the course.
I do not have a support system of friends & family. Almost no one even knows I'm going through this. She has encouraged me to try & take a step to find a support person closer to me. She is 2 hours away & in an emergency, she wants me to have someone closer. She has given me permission to call on her for help if I need it, but asking for help is not something I do very well.
This relationship is for a time in my life for healing. We will not be friends and hang out. It has one purpose and only one. It is strange to me to learning to do something like total trust with someone who the goal is to eventually, someday, be without. Learning to open up completely as one does in an intimate relationship w/ a friend or spouse. I've never really done that. I've stayed as self-sufficient as possible and up until recently, thought I was in control. As things have started to surface, I've discovered that I have a system that has functioned pretty well for the most part, but is not to happy with me messing w/ the program. I find myself in this in between place of not feeling like I'm able to rely on me anymore, but not having a support system to call on either. I never saw the need for it.
When I really started to get a grip that I had many symptoms of DID & needed to find out for sure what was going on, my plan was to go far out of town & find someone to help me figure it all out. I would be in therapy for about a year & would do everything right, so I could get it done & no one would ever know I was in therapy. Boy was I living in "Never Never land." This is the hardest thing I have ever done. Hiding was so much easier.
Lenore
It seems to me the therapeutic relationship is exactly where you work on issues of attachment and trust. I've been seeing my therapist for almost 6 years. Not all of me trusts her yet - or anyone else for that matter. Working through those trust issues must be done in a relationship. My relationship with this therapist - I've seen others over the years - but my relationship with this therapist is unlike any I've ever had because she recognizes the issues with trust and helps me confront trust issues as it affects my ability to work with her to heal the damage my many parts have experienced.
I'm not so reliant on my therapist that I cannot function without her - at least not these days. I have learned to go through object permanency with my younger parts and recognition that the therapist - like many other important people in my life - will come back from holidays, will return my calls if I'm having a melt down I can't sort out on my own, will be there (within reason) for me to help me sort out the complexities of living my life.
There are some major developmental milestones that younger parts cannot work through unless they have the kind of unique relationship that openly addresses trust and attachment. Once the parts learn trust in that therapeutic relationship their development and growth goes along in leaps and bounds. They then can learn to trust each other inside. It hasn't been an easy struggle confronting trust in the therapeutic relationship - and I'm not yet done - but the "relief" I experience when a part learns to trust that relationship and others inside is worth all the grief and effort it took to get there - but get there you must to heal!
I - parts of me - continue to hold my therapist at a distance AND recognize that this is a different relationship from any other I have had or will have with anyone else. But it is slowly and somewhat painfully working on issues of trust and relations that my parts have been able to learn to each heal from their own issues. Until each part learns to trust, they don't seem to heal. My guess is that most people with DID have major issues with attachment and trust. There is some good literature out there that deals with attachment, trust and DID.
I wonder if progress can be made if we don't learn to trust and relate closely with our therapists. Until my parts- each one in it's turn and own way - trust my therapist it's like banging my head against a wall and I'm in for melt downs that can go on for what seems like forever. If you run into a brick wall of resistance, I'd suggest you look at issues of attachment and trust within the therapeutic relationship as it will REFLECT BACK TO YOU the issues the part in question are struggling with. If you resist that, you resist healing.
It seems complex but whenever I give in and invest in my therapeutic relationship, parts begin to move through the developmental stages they missed with ease. I hope you can work with your therapist directly on trust issues - one little step at a time - so you can learn how it feels. One brick at a time and the wall WILL eventually come down.
Laurie
Holly
You correspondence with Laurie brings up a question that I'm experiencing now.
How do you learn to trust someone (therapist) and keep them at a distance at the same time?
Hi Lenore,
I can only speak to my experience, but for me, it isn't really about keeping a therapist at a distance. It's more about respecting the existing limits of the therapuetic relationship. To explain, I'll just tell you how I see it for myself, with the understanding that my perspective isn't necessarily the same as others'.
My therapist is not my friend. I and my insurance company pay her in exchange for services rendered. Our relationship is a professional one, not an intimate one. Intimacy, by definition, involves a mutual exchange of vulnerability and trust. Therapy is not a mutual exchange of vulnerability - it's one sided vulnerability, as well it should be. I think where people get confused (because I do think many people confuse the therapuetic relationship with an intimate one) is because as clients, we are sharing very intimate, personal information. It's easy, I think, to then think there is an intimacy with the therapist that doesn't actually exist. But really, we go to medical doctors who know very intimate details about our physical bodies without laboring under the illusion that our doctors are more than simply professionals whom we've hired to do a job. The same is true of therapists.
Knowing that, it isn't necessary for me to keep my therapist at a distance. And trusting her isn't hard, in part because I understand and respect the boundaries of the "relationship." In fact, her professionalism is precisely how I and my system are able to trust her. This is why, I believe, firm boundaries are so important in therapy. It's really hard, if you have trust issues, to open up to someone when the boundaries are fuzzy or inappropriate.
Hi Holly
Interesting point about the cycle but I think the cycle is intended to help us see that we all cycle - the therapist component is simply saying that our relationship with our therapist changes as we go through the various bits and pieces of work that we have to do to get through this thing called DID.
The cycle, if you look at it from a broader perspective is - at least to me - a lot like the various "stages" or components Kuebler-Ross describes in her death and dying literature. It's a grieving process - every new awareness is a grieving process to an extent because we must - each part, the host, and the system - must redefine our reality based on new information that we learn about ourselves. Our perception of self or selves must change as we change and that necessitates a process - grieving is part of that process.
To call anything a cycle and see it rigidly as moving from here to here to here is also not the way we should look at "cycles" or stages or phases. It's a process and sometimes we move forward and sometimes backward and sometimes there's something that has no real fit in the cycle. What is important is to understand that we go through stages. When I recognize that I'm having a melt down, that usually indicates to me that there will be movement forward if I can figure out and get through the work that is before me and feeling like a melt down.
So I've come to learn that as much as I hate the downward swing there is always something better on the other side and I almost always function better in the end. To me that is what that "cycle" helped me to see. I don't feel compelled to go through it nor does the therapist compel me to go through it. We both recognize there is movement taking place with the deterioration in mental function and both recognize that things will get rocky - sometimes very rocky - before it gets better - because that is the way it is for me (and apparently for others I've talked to about this).
We both also recognize that our relationship will change as a result of this downward swing - it will be permanently different - because the work I am going through often times necessitates that she too must work and possibly change so that we - she and I and my system - can understand those issues we are working on together to get me through. It's not good enough that the therapist says I interact with my clients this way and you will be treated the same way even if it's a problem for you - pushes your buttons. So for example, she seldom says anything about her - which is the way it should be to an extent - but in taking that stance some of her responses to our interactions felt like she was speaking in code - keeping secrets from me. I came to understand that my systems perception was that she was keeping secrets and secrets for me usually meant terror was pending.
You can't get support if the person offering it is perceived to be a potential source of terror. After some months of distressing interactions and communications one day she asked - is the difficulty we are having relating related to something about the way you were brought up? When I heard the question all of a sudden we both - she and I - had clarity and we could work on our communication so I wasn't frightened by it and I could get on with working on the issue of secrets and terror. That is what the therapist stages are about in the cycle. About me but about her too and we have both changed as a result of it. Not therapist focused - me focused - all about me but she and I are in a relationship - by virtue of our interactions - and that relationship mirrors what I am working on in many ways. Any relationship you have is impacted by and reflects not only your own history but also the other parties history. If you want to improve that relationship or figure it out, then you need to see how you are reflected/reflecting and the other party is reflected/reflecting. Then you need to air it so both parties are aware of what is going on - only then can you change yourself and the relationship. I never had an opportunity to learn to relate in a healthy way with people, as the cycle reflects, my relationship with my therapist is the learning tool to help me get through some very fundamental developmental gaps resulting from abuse and resulting DID.
I hope this helps you better understand (at least as I see it) the importance of your relationship with your therapist and how that relationship is, in fact, affected by and changes (or should change) as a result of your experiences - both before therapy and within therapy. It's not at all about the therapist (or shouldn't be) it's about your interactions with the therapist that facilitates healing.
Laurie
Hi Laurie,
Thanks for clarifying. I
'm afraid we'll have to agree to disagree - both about the cycle and all of its steps applying to all and about the importance of the therapuetic relationship. Are therapists important? Yes. Can they play a vital role in healing? Absolutely. But I don't subscribe to therapuetic models that place what I see as too much weight on the "relationship" with the therapist. That, in my opinion, leads to an unhealthy dependence on the therapist. It's one thing for me to acknowledge the role therapy and the therapist play in healing. It's another altogether for me to rely so heavily on my therapist and our "relationship" that it becomes the primary, and often only source of growth and healing. The former I'm happy to do. The latter I quite firmly am not.
Hi Bryan,
Hi too to anyone else facing mental health stressors,
I'm still thinking about you and hoping that you are finding some moments of peace amongst all the confusion.
I don't expect that much has improved for you yet but I keep hoping for you that it will. It is normal that a new diagnosis a chaotic time. That doesn't make it any easier for the person going through it, but maybe it can be a little light of hope, things do get calmer.
I wanted to remind you that your mental illness is not something you need to conquer instantaneously. You will need time and help from other people. Reading suggestions and other self help activities are fantastic but don't put yourself under too much pressure to work everything out right away. Some things you can control, and some you can't, and that is not your fault or your failing... that is just how things are. Work hard to stay safe and look after yourself, you deserve it.
Try not to feel ashamed that your brain is different - you don't need to apologise. It is not your personal failing. There is a place for you in this world, as you are. The world still needs you, your skills and your personhood. You will find a way to live well again.
You might need help organising things. Ask. Try to be patient with yourself.
I'm thinking of you, I wish you all the best.
Hi anon,
"I wanted to remind you that your mental illness is not something you need to conquer instantaneously. You will need time and help from other people. Reading suggestions and other self help activities are fantastic but don’t put yourself under too much pressure to work everything out right away."
Excellent insight and advice. And a good reminder for all of us - certainly for me! - no matter where we are on our healing journey. Thank you.
Bryan-
I often do not come back to read the comments left after I post on one of Holly's blogs however this time I am glad I did. I wanted to throw a couple things out there just to think about.
The first is that it is possible to have two psychiatric diagnosis. I have a friend that had Obsessive Compulsive Disorder and depression. It is (in theory) possible that you have both.
Another thought is that if you do have DID there could be a part )or your system as a whole not wanting you to know they are there and essentially "pretending" to be schizophrenic.
Neither of these may be what is going on but both are food for thought.
bits of Dana
To everyone:
I'm glad my comments have been helpful.
It goes a long way to know that what we are experiencing is part of the process. If we are aware of the process it can help us learn to work with it rather than fight it.
I constantly remind myself that "this too will pass" and I'm learning that usually once it has, I've come out in a better place.
Know that while it feels like the most difficult thing you've ever done in your life (at least that maybe you can remember) it will be worth it and there will be time to enjoy your accomplishments (before it begins again!) I make a point of sitting back, taking a breath and enjoying the lightness that results from each run through the cycles leading to wellness.
Laurie
Laurie:
Thank you so much for writing about the cycle. I had just begun to identify a pattern in my own experience, but reading your description has helped me see that it is part of the process.
Thanks from me too!
Laurie:
Thank you so much for writing about the cycle. I had just begun to identify a pattern in my own experience, but reading your description has helped me see that it is part of the process. I have also started to share more of my feelings with my therapist as it is happening which is helping me move forward.
Holly:
It is so helpful that you share your experience of the most difficult times. Thank you so much and I hope you continue to feel better.
Thank you also to everyone else who has commented on this post. I have found many of the comments to be incredibly informative, as well as reassuring.
Hi Blue Collage,
Thank you so much for the well wishes. And for letting me know that sharing my experiences is helpful to you. That's what makes it worthwhile. :)
"I have found many of the comments to be incredibly informative, as well as reassuring."
I have the same experience. The discussion is so educational and validating. Glad you're a part of it.
Holly,
I’m glad that you have started to see your way out of the canyon and you’re feeling better. It’s funny how our physical health will sooner or later make us do what we refuse to do or avoid doing by switching or dissociating. I always relish the relief when I get back out of the hole I landed in and wallow for a while in it before starting back into the work of recovering from DID.
I’ve found some strategies that help to speed that process up once I realize I’m hanging on the edge. At times when some thoughts or perceptions on the part of my parts are fairly stubbornly holding onto my secrets, it is possible to work actively to help them move through the inevitable with the least amount of disruption to my life. Let me try to explain.
Doris Bryant, Judy Kessler, and Lynda Shirar wrote a book called “The Family Inside: Working with the Multiple.” I’m not sure if it’s still in print but I managed to get two copies used – one for me, one for the psychologist – check online it wasn’t that hard for me to get my copies. What I use a lot in the book, and what the therapist has seen in my patterns of behavior, is “The Multiple’s coping cycle.” It describes an 8 phase process that is evident as someone with DID deals with a trigger – whether they are aware of the trigger or not. (Or aware they are going through the cycle or not) – I found knowing I was going through the cycle and what was happening helped me move through it. So here’s the cycle as they illustrate it:
Phase 1: Triggers – Characterized by Anxiety and Chaos
Phase 2: Headaches – the multiple tries to repress information
Phase 3: Manic Behavior – Attempt to stay in denial – Exhaustion
Phase 4: Memories and Feelings including Body memories, self-abuse, feelings of fear
Phase 5: Abreaction and Depression – Overwhelming feelings, Extreme anxiety, withdrawl, and Paranoia
Phase 6: Suicidal Ideation – Massive depression, No trust, Feels disconnected from therapist
Phase 7: Borderline Symptoms – Transfers onto therapist, Feels abandoned and rejected, Becomes angry with therapist
Phase 8: Resolution – Reconnects with therapist, Assimilates learnings, Goes back into denial until the cycle begins again back at Phase 1
Each time you go through this cycle the denial at the end is less, if you are aware of the cycle it helps. If more conscious parts are aware and try to retain or journal the details of the knowledge they extract while experiencing this cycle, movement toward awareness and feeling better is more rapid in future. It has been my experience that some phases are experienced for longer periods of time while at other times when I’m in this cycle I gloss over some phases. So for example there are times, some of my parts, escalate in their lack of trust in the therapist and feelings that she doesn’t care or they are even angry with her for asking the question that triggered the cycle. This can go on for weeks or months even, before there’s a reconnection with the therapist and a relief of the negative feelings and symptoms experienced as a result of the trigger. For some parts or with some issues for example, the suicidal phase sometimes never becomes an issue – not all phases are present or consciously present for great lengths of time. I’m getting better at recognizing the cycle and working through the issues. I try not to avoid telling the therapist how I’m feeling and what I’m experiencing, I try to allow myself to be aware of what my system is telling me – when I avoid it the process can drag on for longer and the pain and distress associated with it goes on longer. I don’t care much for the experience so I’m getting smarter about asking the parts inside for help and information, sharing that information with the therapist and trying to consciously and actively go through the process. The book does a good job of describing the phases and I’ve found it to be one of my many invaluable resources when I’m in Phase 5 and trying to find answers to help me decipher my distress. Each time I roll back into the cycle again I try to remind myself that we-all will survive this cycle, like we did the last one, and we will feel much better for it.
Hope this helps.
Laurie
Hi Laurie,
Thanks for your comment.
I've heard people talk about the cycle you describe before. I have to say, though, I don't agree that it's "The Multiple's Coping Cycle." I believe people with Dissociative Identity Disorder are each very unique and handle stressors in their own individual ways. Anytime a therapist attempts to pin down precisely what happens within every single DID system across the board this way, they end up missing out on a lot. It's also very therapist focused - perhaps more clinicians should realize that our lives don't, in fact, revolve around them! If I'm decompensating, it rarely has anything to do with my therapist.
Having said that though, I will say that if this cycle works well as a guide for you and others, that's wonderful. Whatever works.
I don't want to muddy the waters for Bryan but I think it is worth mentioning the possibility that schizophrenia and DID are not necessarily mutually exclusive. It is possible to have symptoms of both. I have. I think most of my problems are DID related but I have had a few serious episodes that professionals recognise as disorganised schizophrenia. So, a schizophrenic alter? Disorganisation as a result of rapid switching combined with severe derealisation? I don't know. I've been treated by professionals with very strong opinions about me having one condition or the other, but I've not been convinced by either. That I have some higly variable major problem in my brain, certainly. That I am chronically mentally ill and I need to manage and treat those symptoms, yes.
For me there is great value in not being too binary about diagnoses. Everything - the various psychoitc, dissociative, and anxiety symptoms - are on a spectrum. This can be hard to work with because it is even more ambiguity to tolerate and if you are applying for disability payments or services, a diagnosis is usually required. For me, and i know this is a very personal position that some other people disagree with strongly, it makes more sense to remain open to the possibilities and treatments of both conditions rather than settling on one diagnosis and ruling out the other.
Holly,
I will admit my first post took a while to write out and took some effort to actually post it. I was scared.. I wasn't sure what to expect in regards to a reply. But honestly, I thank you and the others that took time to read it and reply. It may seem pety and all, but you all have given me some hope.I will pick my self up and head to the book store to see if I can find Deborah Haddock and Marlene Steinbergs book.
My friend thats around me the most is like a 2nd mother to me, Its a strange story actually. She's the mother of my good friend (brother if you will) of 18 years. Me and him meet in middle school about 18 years ago and have stayed very close ever since. his mom has been a 2nd mother to me. We spend a lot of time together, She has been on the front lines battling with me throughout all this. I love her and I love him they are both great people, But I feel like I can't rely on her for much (reguarding DID/Schizophrenia) or anything
I know that may sound bad but it really isn't.. I could write for years about whats happened in my life, she knows pretty much everything, the good, the bad and the ugly. One day she talked to me about DID and I may be wrong (I hope I am, I think) but I feel like shes stuck on a diagnosis for me and won't listen or move. I've just started mentioning Schizophrenia to her as a possibility, its like she doesn't want to hear it (maybe doesn't want to believe it) I'm not sure. You mentioned keeping tabs on me and writing things down about my everyday life, It may not be something I can do myself, I will ask her to though.
You asked "Do you instinctively have a feeling about either diagnosis now? If so, ask yourself why. " I can honestly relate to both disorders, when I start reading about either one of them, or talking about it I get very upset. The frustration kicks in, emotions start running wild, I get angry and leave. I don't want to hear it... I know I'm better then this! I'm a carpenter/handy man, I was a musician. I've done a lot of wonderful great things in my short 28 years here on earth. I think about it a lot, quite often actually and it just rips me apart. I read about people that are worse off then I am or at my same level (I don't want to sound selfish or anything i hope you dont take it that way) I know inside, in my heart I can't be like them, or ME. I'm not who I am (or was) anymore.. I could spend my life looking for myself but I sometimes feel its almost as pointless as trying to see life through 1 set of eyes.
I honestly don't know who the real me is anymore, I've done some terrible things in my life to the very people I love(d) with all my heart. I think back and just can't bring myself to the realization that it was ME. I've never done the things I've done.. I would never hurt the people I've hurt the way I've hurt them... ... I had to take a few sorry....
About my mother.. I know only a small amount of what she has been through in her life. I can only imagine the things shes seen/been through. Deep down inside I know its not her fault shes doing what shes done to me. She has always been depressed or suicidal from the youngest years I can remember. Things changed when my "Dad" left us basically for dead.. Cleaned out bank accounts, just up and left my mom with 3 kids. (I'm middle brother, younger & older .. neither have depression or anything.. I got all the issues). She spent the next 16 years going through the same process, therapy, medication etc... My dad left for 3 years and returned.. Now, only about 6 i think 7 years ago is when it all got worse.
She was hospitalized for 7 days after a few times of having the police called on us. She would leave the house and scream at 2 or 3am.. she would walk down the street and tell people my dad was holding her captive and she escaped. Things only got worse from there... I won't get too in depth with her story as I believe its as personal as mine.
I believe she was diagnosed right, I just believe she is was worse off then me. She's on medication and seems to function normally sometimes, but she has her moments. But I think thats pretty much where the similarities end between my mother and I. It didn't hit her till she was in her 50's.. I'm going to be 29 in 5 months and don't have much of anything to look forward too.
I need to take a break from this.. It's beginning to be a little too much for me Im having a hard time writing this..
Holly, Anon, Sue and Paul.. Thank you all! You have all helped me, given me ideas to further better myself and educate myself. I'll talk to my friend about documenting my day - to - day experiences.
I'll do my best to read, Like I said earlier I will head out later and see if I can find the books. I'm going to go get some fresh air and walk around.. We've got beautiful weather in Northern California, Guess I should take advantage of it... Thanks again all of you!
Holly, Thank you for writing this. I hope it helped you to say where you are at now.
I completely understand where you are at.
For me, I try to do these "healthy" things before I fall too far because they help modulate things. I know that, but I'm not always able to do that. I try and try and try.
For Bryan: I would think that a good clinician can help you distinguish what is really going on for you. DID and schizophrenia are only similar when viewed from a big distance. I would keep talking and help people learn about you (and you about yourself) so that you can figure this out. Good luck.
Paul
Bryan - Holly eloquently said, "I know you said your mother had Schizophrenia but sometimes it’s easier to get perspective by looking outside of the familiar". While reading your initial post and then Holly's words, I wanted to suggest that depending on when (how long ago) your Mom was diagnosed, it's possible she herself was not accurately diagnosed. I agree with everything the others said and I think it's wonderful that such amazing people exist, identify real-time resources, and really care. I care, too, Bryan. Stay strong while you search.
Holly - I recently began spending time at Healthyplace.com and saw a few of your posts and videos. I'm sorry to hear you've had a set back and wish you strength to reach the level you desire.
Hi Sue,
Thank you. :) I'll get there! I'm nothing if not stubborn.
Hi Holly,
Got the newsletter today and saw you've not been well, just wanted to pop in and say I'm so glad you've got such loving, compassionate support and it appears from the many comments, many caring followers too.
Be kind and gentle with yourself, you're an amazing woman with much to share and just wanted to wish you all the best and will be thinking of you.
Hugs! Barb
Barb, you are so kind. Thank you for taking the time to visit and leave this lovely note. I truly appreciate it.
Hi Bryan,
It sounds like you are going through a difficult time with diagnoses and trying to work out some support and treatment. I feel your desperation and confusion.
"Not truly knowing what I have is ripping me apart and totally messing my already messed up life."
Yes, this not knowing is hard and can make you feel very lonely. There may be some comfort in settling on a diagnosis and working through some treatments. Unfortunately, my experience is that even when people "know" what they have, there is still a WHOLE GIANT BOOTLOAD of stuff that they don't know and don't understand about what is going on in their brain. The doctors might seem evasive because they don't know either...
Getting to understand your atypical neuro/psychological reality takes AGES. You need to document your experience any way you can - I notice that you write clearly, maybe diary writing could work for you. Even just jotting daily notes about your symptoms can help some patterns start to emerge. Both schizophrenia and DID are managed/treated over the long term so it's worth investing time and effort observing your patterns.
Perhaps there is someone else in your life who can help document and reality check for you? Often other people don't notice (Holly has helped me understand why that is - DID is designed to conceal itself and we feel shame so we actively conceal symptoms) but sometimes even casual observations from others can be very illuminating or reassuring. I have trouble with auditory hallucinations and I find that just having a friend tell me whether they can hear anything and what it might be, can help me feel less afraid or overwhelmed. Over time I came to realise that most of the time I am hearing something that is real but I am mishearing or thinking something bizarre about the source of the sound. Even though this "hearing problem" is still a pain in the ass, and can be embarrassing/difficult/upsetting, I feel better and safer knowing something about the mechanics of what is happening. And I find this kind fo insight much more useful than nutting out whether this symptom is technically a "thought disorder" or "hallucination" and "auditory processing problem" or an alter messing with me.
I know that for other people, getting a formal diagnosis can be very important and I support you in that quest if that is what you need to feel more stable. In the mean time, perhaps you could try to mitigate one symptom at a time. Is it the "crowded airport" feeling that freaks you out the most? Is it the anxiety around your unusual experiences? Ask your health professionals to help you with that particular symptom. They may recommend meds, then you can decide if they seem like a good option for you, or maybe try them for a bit. Relaxation might help. Distraction and absorption in something you love to do might help. Excercise... Whatever works for you. I HATE anything like meditation but I find going for a good long walk great. These are not cures, but regardless of your condition/disorder/illness they might help improve your quality of life.
I hope that this helps in some way, I wish you all the best.
I'm not 100% sure this goes with the above post but holly, I've been following your blog for a while ever since I "was" "diagnosed" with D.I.D. I've spent the past few months preparing myself for the very long road ahead. Now I've come to find out I could be "Schizophrenic" and not D.I.D. I don't know what to believe anymore, the few friends i have that know say I have a lot of the warning signs of D.I.D. There have been times where I've experienced dissociative amnesia, and others.
But now to hear that i'm "Schizophrenic" and from what I've read they really aren't that far off from each other but yet are so different. am I right? or am I just totally not seeing this? I'm confused, nobody can tell me what is wrong with me and its killing me. I grew up and had a TERRIBLE life, Have a mother that is Schizophrenic (which leads the drs to believe thats what I have) and she was abusive mentally and psychically.
I don't know what to think! My mind feels like a crowded airport during thanksgiving or Christmas.. Not truly knowing what I have is ripping me apart and totally messing my already messed up life. Any advice you can give? I'd appreciate it, Therapy and doctors aren't helping me.. Maybe someone who reads this can...
Hi Bryan,
I'm really glad you commented. I can imagine how confused and frustrated you must be. I think reaching out and seeking more information will eventually pay off for you. It may take some time though.
If I were you, I'd educate myself as much as possible about both diagnoses. Have you read The Dissociative Identity Disorder Sourcebook by Deborah Haddock? If not, do. See if you recognize yourself in the pages. Read The Stranger in the Mirror by Marlene Steinberg (the creator of the SCID-D, a highly respected diagnostic tool for dissociative disorders). That book offers some very basic screening tests at the end of each chapter. I encourage you to read each chapter entirely before taking the respective tests and don't overthink it. Remember, it's just a screening test to give you a better understanding of your level of dissociation.
Visit the isst-d.org and sidran.org ... both offer a wealth of information on trauma and dissociation. You may also be interested in reading some other DID blogs. I'd caution you to choose carefully there. There is a lot of misinformation floating around about DID and unfortunately some of it is perpetuated by some DID bloggers. Two bloggers I respect and recommend highly are Paul at mindparts.org and CG at scatteredpieces.org - both offer a balanced, insightful look at their own experiences with and perspectives on DID.
As for Schizophrenia, I don't have a lot to offer. John Cadigan has Schizophrenia and filmed his life for years for his documentary film People Say I'm Crazy. If you can, watch it. This will give you an inside look at life with Schizophrenia - I know you said your mother had Schizophrenia but sometimes it's easier to get perspective by looking outside of the familiar. Also, if you're on twitter I recommend you follow John - @pplesaycrazy - he regularly posts links to articles and information about Schizophrenia and the beauty of that is that John has personally selected those links and if anyone knows Schizophrenia, it's John Cadigan.
We had a woman on the HealthyPlace Mental Health TV Show recently named Sandra Yuen MacKay. She wrote a book called My Schizophrenic Life that details her life with Schizophrenia. It's a remarkable little book and a quick read. Watch her interview here: http://tinyurl.com/69k2g6d
The point is, psychoeducation is vital. Ultimately you are the expert on you. As you educate yourself about both diagnoses, I'm guessing one will begin to resonate with you more and more. Do you instinctively have a feeling about either diagnosis now? If so, ask yourself why.
One of the points I try hard to drive home is that living with Dissociative Identity Disorder requires that we learn to tolerate ambiguity. You're doing that right now. It's uncomfortable, it's confusing, it's hard. But if you can resist the urge to rush the process, and learn as much as you can about what both disorders are and what they are not, eventually you will have a solid understanding of both and better able to help your doctors discern what's going on for you.
I know I've inundated you with a lot of information here. Please keep reading and asking questions. This confusion will not last forever. You can find the answer.
Byran I knew as I was typing my earlier comment to you that some readers would come and offer things I was missing. And sure enough, they did! I concur wholeheartedly with anon, Sue, and Paul's suggestions.
- anon suggested documenting your experiences. excellent advice, particularly if you're dissociative. over time you may begin to see patterns and glean insight from them.
- Sue pointed out the possibility of an inaccurate diagnosis of your mother's disorder. DID and Schizophrenia can easily be mistaken for one another, though once you begin to understand both more deeply that may surprise you. Like Paul pointed out, "DID and schizophrenia are only similar when viewed from a big distance."
-Paul recommended seeking the expertise of a good clinician. I know you've seen and are seeing doctors but I'd echo Paul's advice anyway. I don't think I'm exaggerating when I say that most clinicians simply don't know nearly enough about Dissociative Identity Disorder to diagnose or treat it. Period. I suspect the same is true for Schizophrenia. It will take leg work, but see if you can find someone who has experience diagnosing and treating not one, but several DID patients. The isst-d.org has a Find-A-Therapist feature. A word of warning: do interview any therapist you contact and ask them directly about their experience with DID. One doesn't have to be particularly skilled to be a member of the isst-d. Membership indicates they've an INTEREST in trauma and dissociation, but not necessarily the expertise to treat either.
I agree with Suede...you are superwoman to me too! You are courageous and honest and a breath of fresh air. I only wish I could see and hear all of the amazing & beautiful creativity that comes out of you, because the little bit I get to see is amazing. <3
Annie,
As much as I'd hate to share you I do wish everyone had a sister as kind and generous as you are. Thank you for being you.
Oh and I'm so delighted to share your flowers with readers ... they're gorgeous!
I am so thankful you checked in, don't ask me how but I knew something was not right and had been checking. Maybe it is cause I spent most of my time on the downside I saw it coming. When you used to losing time and no energy you get used to it, it becomes the norm. But I fight cause I want more. Solitude is a big one sadly I don't get much of that.
Now that I know I need it though I am starting to ask for it.
I am in awe at your bravery for being open and honest about DID. I sill live in secret to almost all. I can not fathom it. So you are superwomen to me!
Thank you
Hi Suede,
"When you used to losing time and no energy you get used to it, it becomes the norm. But I fight cause I want more."
Oh boy, yes. I feel the same way. I'm not content to resign myself to the amnesia, exhaustion, etc. Like you, I want more. And I believe the fight is worth it.
"Solitude is a big one sadly I don’t get much of that."
Solitude is a big one for me too. I'm very glad you're beginning to ask for what you need. I find that the difference between my mental state when I'm getting plenty of alone time and when I'm not is huge.
"I sill live in secret to almost all. I can not fathom it."
I understand, truly. If someone had told me a year ago that I'd be totally "out" about having Dissociative Identity Disorder I would have laughed bitterly. It's amazing how things can change.
Thank you so much, Suede, for reading and taking the time to comment.
Rest, solitude, and quiet sounds like good medicine for the soul. I'm very glad that you are climbing your way back up now with the love and support that you deserve. The flowers are beautiful.
I do agree that we are probably lucky that we have DID to soften the blow when we fall. Take care.
Thank you, Mareeya.
I hope you're taking good, gentle care too. You deserve love and support too.
Glad you're back and okay. It is reassuring to know you have a support system at home in place to help you. Please know you have one here also.
Hi Lenore,
You know, when I started blogging I did so with one goal in mind: humanize and demystify Dissociative Identity Disorder. It never occurred to me that I might find support and encouragement of my own in the process. It's truly been a blessing. Thank you.
What a beautiful bunch of flowers your sister sent you Holly. I can feel the love coming from them just by looking at the picture. Glad you are being well taken care of. I have a feeling more than a few of us faithful readers were concerned about you, but I'm sure we can all relate. Keep taking care.
Hi carla,
" ... I’m sure we can all relate."
I agree. I suspect all of you know what it's like to lose your footing and take a mental health tumble. I'm lucky I have plenty of hands to help me get back up. My hope is that in my own small way, I can provide others a hand.
Thank you, carla, for your thoughtful comment and your participation here at Dissociative Living. I so appreciate the feedback, insight, and community all of you have created.
Thank you for the chat today Holly. It was so nice to hear from you. I know all too well what the bottom of that cliff looks like. As I read this article something stood out to me and I thought I would share. You are taking care of yourself as you "climb back up" and doing the very same things that are good things to do when you see yourself deteriorating. It is important to take care of yourself. And when you are declining that is even more important. I thought perhaps I would share a list of things I do to take care of myself when my mental health is declining.
- color
- allow myself to cry
- rest
- watch mindless TV
- play pointless video games
- sleep
- lay in bed and cuddle my dog
- eat ice cream and other comfort food
- listen to soothing music
- take a time out from life for a few hours
- eliminate extra stressors
- allow someone to just hold me
- relax
- breath
I hope this helps some and gives you something to think about as to what you can do when you are noticing those warning signs. You are an amazing woman and we love you all. We care!
Dana etc.
Hi Dana,
Thank you so much for sharing that list.
"You are taking care of yourself as you “climb back up” and doing the very same things that are good things to do when you see yourself deteriorating."
You know, that's a really good point. I'd never thought of that before. If we respond to mental health warning signs with the same actions and choices we'd engage if we were in meltdown mode, we might stave off the meltdown. It seems so obvious now. Thank you for pointing that out!