diagnosis

Calling it lunacy makes it easier to explain away the things we don't understand.

I am truly crazy, I told myself. It's over. I am not fixable. I cannot tell Tom. I cannot even tell Francisco. So I won't tell anyone. My brain seemed out of control. Tom does not deserve a crazy wife and my children do not deserve a crazy mother. I finally get it. This is not just repressed memory. This is dissociative identity disorder.

the essential feature of the Dissociative Disorders is a disruption in the usually integrated functions of consciousness, memory, identity,or perception

In this chapter I restrict myself to exploring the nature of the amnesia which is reported between personality states in most people who are diagnosed with DID. Note that this is not an explicit diagnostic criterion, although such amnesia features strongly in the public view of DID, particularly in the form of the fugue-like conditions depicted in _ms of the condition, such as The Three Faces of Eve (1957). Typically, when one personality state, or __lter_, takes over from another, they have no idea what happened just before. They report having lost time, and often will have no idea where they are or how they got there. However, this is not a universal feature of DID. It happens that with certain individuals with DID, one personality state can retrieve what happened when another was in control. In other cases we have what is described as __o-consciousness_ where one personality state can apparently monitor what is happening when another personality state is in control and, in certain circumstances, can take over the conversation.

Although it is important to be able to recognise and disclose symptom of physical illnesses or injury, you need to be more careful about revealing psychiatric symptoms. Unless you know that your doctor understands trauma symptoms, including dissociation, you are wise not to reveal too much. Too many medical professionals, including psychiatrists, believe that hearing_voices_is a sign of schizophrenia, that mood swings mean_bipolar_disorder which has to be_medicated, and that depression requires electro-convulsive therapy if medication does not relieve it sufficiently. The __edical model_ simply does not work for dissociation, and many treatments can do more harm than good... You do not have to tell someone everything just because he is she is a doctor. However, if you have a therapist, even a psychiatrist, who does understand, you need to encourage your parts to be honest with that person. Then you can get appropriate help.

As it stands, the diagnostic criteria for depression are so loose that two people with absolutely no symptoms in common can both end up with the same unitary diagnosis of depression. For this reason especially, the concept of depression as a mental disorder has been charged with being little more than a socially constructed dustbin for all manner of human suffering.

Having DID is, for many people, a very lonely thing. If this book reaches some people whose experiences resonate with mine and gives them a sense that they aren't alone, that there is hope, then I will have achieved one of my goals. A sad fact is that people with DID spend an average of almost seven years in the mental health system before being properly diagnosed and receiving the specific help they need. During that repeatedly misdiagnosed and incorrectly treated, simply because clinicians fail to recognize the symptoms. If this book provides practicing and future clinicians certain insight into DID, then I will have accomplished another goal. Clinicians, and all others whose lives are touched by DID, need to grasp the fundamentally illusive nature of memory, because memory, or the lack of it, is an integral component of this condition. Our minds are stock pots which are continuously fed ingredients from many cooks: parents, siblings, relatives, neighbors, teachers, schoolmates, strangers, acquaintances, radio, television, movies, and books. These are the fixings of learning and memory, which are stirred with a spoon that changes form over time as it is shaped by our experiences. In this incredibly amorphous neurological stew, it is impossible for all memories to be exact.But even as we accept the complex of impressionistic nature of memory, it is equally essential to recognize that people who experience persistent and intrusive memories that disrupt their sense of well-being and ability to function, have some real basis distress, regardless of the degree of clarity or feasibility of their recollections. We must understand that those who experience abuse as children, and particularly those who experience incest, almost invariably suffer from a profound sense of guilt and shame that is not meliorated merely by unearthing memories or focusing on the content of traumatic material. It is not enough to just remember. Nor is achieving a sense of wholeness and peace necessarily accomplished by either placing blame on others or by forgiving those we perceive as having wronged us. It is achieved through understanding, acceptance, and reinvention of the self.

We must understand that those who experience abuse as children, and particularly those who experience incest, almost invariably suffer from a profound sense of guilt and shame that is not meliorated merely by unearthing memories or focusing on the content of traumatic material. It is not enough to just remember. Nor is achieving a sense of wholeness and peace necessarily accomplished by either placing blame on others or by forgiving those we perceive as having wronged us. It is achieved through understanding, acceptance, and reinvention of the self. At this point in time there are people who question the validity of the DID diagnosis. The fact is that DID has its own category in the Diagnostic and Statistical Manual of Mental Disorders because, as with all psychiatric conditions, a portion of society experiences a cluster of recognizable symptoms that are not better accounted for by any other diagnosis.

Janna knew - Rikki knew _ and I knew, too _ that becoming Dr Cameron West wouldn't make me feel a damn bit better about myself than I did about being Citizen West. Citizen West, Citizen Kane, Sugar Ray Robinson, Robinson Crusoe, Robinson miso, miso soup, black bean soup, black sticky soup, black sticky me. Yeah. Inside I was still a fetid and festering corpse covered in sticky blackness, still mired in putrid shame and scorching self-hatred. I could write an 86-page essay comparing the features of Borderline Personality Disorder with those of Dissociative Identity Disorder, but I barely knew what day it was, or even what month, never knew where the car was parked when Dusty would come out of the grocery store, couldn't look in the mirror for fear of what__r whom__'d see. ~ Dr Cameron West describes living with DID whilst studying to be a psychologist.

What daily life is like for __ multiple_ Imagine that you have periods of __ost time._ You may find writings or drawings which you must have done, but do not remember producing. Perhaps you find child-sized clothing or toys in your home but have no children. You might also hear voices or babies crying in your head. Imagine that you can never predict when you will be able to have certain knowledge or social skills, and your emotions and your energy level seem to change at the drop of a hat, and for no apparent reason. You cannot understand why you feel what you feel, and, if you are in therapy, you cannot explore those feelings when asked. Your life feels disjointed and often confusing. It is a frightening experience. It feels out of control, and you probably think you are going crazy. That is what it is like to be multiple, and all of it is experienced by the ANPs. A multiple may also experience very concrete problems, even life-threatening ones.

I recently consulted to a therapist who felt he had accomplished something by getting his dissociative client to remain in her ANP throughout her sessions with him. His view reflects the fundamental mistake that untrained therapists tend to make with DID and DDNOS. Although his client was properly diagnosed, he assumed that the ANP should be encouraged to take charge of the other parts at all times. He also expected her to speak for them__n other words, to do their therapy. This denied the other parts the opportunity to reveal their secrets, heal their pain, or correct their childhood-based beliefs about the world.If you were doing family therapy, would it be a good idea to only meet with the father, especially if he had not talked with his children or his spouse in years? Would the other family members feel as if their experiences and feelings mattered?Would they be able to improve their relationships? You must work with the parts who are inside of the system. Directly.

I think the stigma attached to mental illness will disappear just like it did for cancer years ago.

...American psychology effectively guaranteed its place as a cultural icon by helping to create the pathologies it simultaneously promised to treat. (p. 37)

When he first said my diagnosis, I couldn't believe it. There must be another PTSD than post-traumatic stress disorder, I thought. I have only heard of war veterans who have served on the front lines and seen the horrors of battle being diagnosed with PTSD. I am a Beverly Hills housewife, not a soldier. I can't have PTSD. Well, I was wrong. Housewives can get PTSD, too, and yours, truly did.

Before you diagnose any sickness, make sure there is no sickness in the mind or heart. For the emotions in a man's moon or sun, can point to the sickness in any one of his other parts.

In this world where value is unknown, but the price of anything is marked, where the creation of self has been abandoned for the search for self, the behavior diagnosed as antisocial is often too quickly ascribed to intelligence when thrust into contact with widespread conformity, and refuses.

THE MAXIMS OF MEDICINE Before you examine the body of a patient,Be patient to learn his story.For once you learn his story,You will also come to knowHis body.Before you diagnose any sickness,Make sure there is no sickness in the mind or heart.For the emotions in a man__ moon or sun,Can point to the sickness inAny one of his other parts.Before you treat a man with a condition,Know that not all cures can heal all people.For the chemistry that works on one patient,May not work for the next,Because even medicine has its ownConditions.Before asserting a prognosis on any patient,Always be objective and never subjective.For telling a man that he will win the treasure of life,But then later discovering that he will lose,Will harm him more than by telling himThat he may lose,But then he wins.THE MAXIMS OF MEDICINE by Suzy Kassem

Rarely do I truly understand the disease which ails me. Therefore, rarely do I truly understand the fix that would cure me. And so maybe I should truly contemplate how rarely I recognize that God understands both.