Question about PTSD

[jazpoppy]

Hi. My name is Jocelyn and I am an addict/alcoholic and I have Anxiety Disorder and severe depression. My councelor has recently told me that I am suffering from PTSD due to a verbal/physically abusive childhood. I have a question pertaining to disassociation. I dissacociated the other evening after a movie on my way out of the theatre. My son was with me. I forgot I had him with me and I could not hear anything going on around me. He yelled for me to stop squeazing his hand about 5 times but I did not hear him until the last time. He told me that he was yelling for me to let go but I didn't respond. Is this something that can happen as a result of PTSD? I have had it happen a few times before within the past 10 years. Please help. Thank you.

Jocelyn

Hi Jocelyn,

I don't have the answer to your question because it's not something I've experienced myself. I know a person with PTSD who loses long blocks of time and doesn't remember anything she does during that time.

I would first rule out the possibility of seizure activity and see a neurologist about it. I've seen seizures that cause the kind of symptoms you're describing.

If your therapist can't answer your questions then I would also see a psychiatrist. You might also ask Mark on his forum upstairs. I'll post a link that may have some information for you.

Hugs,
MG

Dissociative Disorders
http://www.sidran.org/
Recently considered rare and mysterious psychiatric curiosities, Dissociative Identity Disorder (DID) (previously known as Multiple Personality Disorder-MPD) and other Dissociative Disorders are now understood to be fairly common effects of severe trauma in early childhood, most typically extreme, repeated physical, sexual, and/or emotional abuse.

In Diagnostic and Statistical Manual of Mental Disorders-IV (American Psychiatric Association, 1994), Multiple Personality Disorder (MPD) was changed to Dissociative Identity Disorder (DID), reflecting changes in professional understanding of the disorder resulting from significant empirical research.

Posttraumatic Stress Disorder (PTSD), widely accepted as a major mental illness affecting 8% of the general population in the United States, is closely related to Dissociative Disorders. In fact, 80-100% of people diagnosed with a Dissociative Disorder also have a secondary diagnosis of PTSD. The personal and societal cost of trauma disorders is extremely high. Recent research suggests the risk of suicide attempts among people with trauma disorders may be even higher than among people who have major depression. In addition, there is evidence that people with trauma disorders have higher rates of alcoholism, chronic medical illnesses, and abusiveness in succeeding generations.

WHAT IS DISSOCIATION?

Dissociation is a mental process, which produces a lack of connection in a person's thoughts, memories, feelings, actions, or sense of identity. During the period of time when a person is dissociating, certain information is not associated with other information as it normally would be. For example, during a traumatic experience, a person may dissociate the memory of the place and circumstances of the trauma from his ongoing memory, resulting in a temporary mental escape from the fear and pain of the trauma and, in some cases, a memory gap surrounding the experience. Because this process can produce changes in memory, people who frequently dissociate often find their senses of personal history and identity are affected.

Most clinicians believe that dissociation exists on a continuum of severity. This continuum reflects a wide range of experiences and/or symptoms. At one end are mild dissociative experiences common to most people, such as daydreaming, highway hypnosis, or "getting lost" in a book or movie, all of which involve "losing touch" with conscious awareness of one's immediate surroundings. At the other extreme is complex, chronic dissociation, such as in cases of Dissociative Disorders, which may result in serious impairment or inability to function. Some people with Dissociative Disorders can hold highly responsible jobs, contributing to society in a variety of professions, the arts, and public service -- appearing to function normally to coworkers, neighbors, and others with whom they interact daily.

There is a great deal of overlap of symptoms and experiences among the various Dissociative Disorders, including DID. For the sake of clarity, this brochure will refer to Dissociative Disorders as a collective term. Individuals should seek help from qualified mental health providers to answer questions about their own particular circumstances and diagnoses.

HOW DOES A DISSOCIATIVE DISORDER DEVELOP?

When faced with overwhelmingly traumatic situations from which there is no physical escape, a child may resort to "going away" in his or her head. Children typically use this ability as an extremely effective defense against acute physical and emotional pain, or anxious anticipation of that pain. By this dissociative process, thoughts, feelings, memories, and perceptions of the traumatic experiences can be separated off psychologically, allowing the child to function as if the trauma had not occurred.

Dissociative Disorders are often referred to as a highly creative survival technique because they allow individuals enduring "hopeless" circumstances to preserve some areas of healthy functioning. Over time, however, for a child who has been repeatedly physically and sexually assaulted, defensive dissociation becomes reinforced and conditioned. Because the dissociative escape is so effective, children who are very practiced at it may automatically use it whenever they feel threatened or anxious -- even if the anxiety-producing situation is not extreme or abusive.

Often, even after the traumatic circumstances are long past, the left-over pattern of defensive dissociation remains. Chronic defensive dissociation may lead to serious dysfunction in work, social, and daily activities.

Repeated dissociation may result in a series of separate entities, or mental states, which may eventually take on identities of their own. These entities may become the internal "personality states" of a DID system. Changing between these states of consciousness is often described as "switching."

WHAT ARE THE SYMPTOMS OF A DISSOCIATIVE DISORDER?

People with Dissociative Disorders may experience any of the following: depression, mood swings, suicidal tendencies, sleep disorders (insomnia, night terrors, and sleep walking), panic attacks and phobias (flashbacks, reactions to stimuli or "triggers"), alcohol and drug abuse, compulsions and rituals, psychotic-like symptoms (including auditory and visual hallucinations), and eating disorders. In addition, individuals with Dissociative Disorders can experience headaches, amnesias, time loss, trances, and "out of body experiences." Some people with Dissociative Disorders have a tendency toward self-persecution, self-sabotage, and even violence (both self-inflicted and outwardly directed).

WHO GETS DISSOCIATIVE DISORDERS?

The vast majority (as many as 98 to 99%) of individuals who develop Dissociative Disorders have documented histories of repetitive, overwhelming, and often life-threatening trauma at a sensitive developmental stage of childhood (usually before the age of nine), and they may possess an inherited biological predisposition for dissociation. In our culture the most frequent precursor to Dissociative Disorders is extreme physical, emotional, and sexual abuse in childhood, but survivors of other kinds of trauma in childhood (such as natural disasters, invasive medical procedures, war, kidnapping, and torture) have also reacted by developing Dissociative Disorders.

Current research shows that DID may affect 1% of the general population and perhaps as many as 5-20% of people in psychiatric hospitals, many of whom have received other diagnoses. The incidence rates are even higher among sexual-abuse survivors and individuals with chemical dependencies. These statistics put Dissociative Disorders in the same category as schizophrenia, depression, and anxiety, as one of the four major mental health problems today.

Most current literature shows that Dissociative Disorders are recognized primarily among females. The latest research, however, indicates that the disorders may be equally prevalent (but less frequently diagnosed) among the male population. Men with Dissociative Disorders are most likely to be in treatment for other mental illnesses or drug and alcohol abuse, or they may be incarcerated.

WHY ARE DISSOCIATIVE DISORDERS OFTEN MISDIAGNOSED?

Dissociative Disorders survivors often spend years living with misdiagnoses, consequently floundering within the mental health system. They change from therapist to therapist and from medication to medication, getting treatment for symptoms but making little or no actual progress. Research has documented that on average, people with Dissociative Disorders have spent seven years in the mental health system prior to accurate diagnosis. This is common, because the list of symptoms that cause a person with a Dissociative Disorder to seek treatment is very similar to those of many other psychiatric diagnoses. In fact, many people who are diagnosed with Dissociative Disorders also have secondary diagnoses of depression, anxiety, or panic disorders.

DO PEOPLE ACTUALLY HAVE "MULTIPLE PERSONALITIES"?

Yes, and no. One of the reasons for the decision by the psychiatric community to change the disorder's name from Multiple Personality Disorder to Dissociative Identity Disorder is that "multiple personalities" is somewhat of a misleading term. A person diagnosed with DID feels as if she has within her two or more entities, or personality states, each with its own independent way of relating, perceiving, thinking, and remembering about herself and her life. If two or more of these entities take control of the person's behavior at a given time, a diagnosis of DID can be made. These entities previously were often called "personalities," even though the term did not accurately reflect the common definition of the word as the total aspect of our psychological makeup. Other terms often used by therapists and survivors to describe these entities are: "alternate personalities," "alters," "parts," "states of consciousness," "ego states," and "identities." It is important to keep in mind that although these alternate states may appear to be very different, they are all manifestations of a single person.

CAN DISSOCIATIVE DISORDERS BE CURED?

Yes. Dissociative Disorders are highly responsive to individual psychotherapy, or "talk therapy," as well as to a range of other treatment modalities, including medications, hypnotherapy, and adjunctive therapies such as art or movement therapy. In fact, among comparably severe psychiatric disorders, Dissociative Disorders may be the condition that carries the best prognosis if proper treatment is undertaken and completed. The course of treatment is longterm, intensive, and invariably painful, as it generally involves remembering and reclaiming the dissociated traumatic experiences. Nevertheless, individuals with Dissociative Disorders have been successfully treated by therapists of all professional backgrounds working in a variety of settings.

[jazpoppy]

MG;

Thanks very much. The article you posted here helped a lot. I have had OBE (Out of Body Experiences) since I was about 14 or so. It only happens when I am napping during the day and I am clean (no drugs, alcohol, etc.). It used to happen everday when I was pregnant with my son. I told some people about it and they said that it was a cool spiritual experience so I believed I could do something cool. Now I believe I may have a problem with disassociation and I am going to talk to my councelor/doctor about these experiences. Thanks again.

Jocelyn

I believe in spiritual experiences, but flashbacks can be mistaken for spiritual experiences. So can migraine headache auras. That's why I always like to rule out the physical before moving to the next step. Flashbacks are so different for each person that I can really only relate to the kind that I had. I was half in the memory and half in the present day so I never completely lost touch with my surroundings. My daughter on the other hand had visual flashbacks that blocked her view for a few seconds at a time. The other friend loses time completely. It's just a real relief to know that you aren't crazy and this is the way to healing. We all reconnect to those blocked memories in different ways.

We're here for you if you want to talk about it or experience any fear or anxiety. Losing control can be pretty scary at times.

Hugs,
MG

[Don W]

Hi Jocelyn, I don't think I've experenced the action you spoke of. Of course, I did have black outs while drinking and who knows what I did. However, I've come close.
I'll be out with my wife or even at home and my mide will go back to a situation that happened years ago. I will say out loud an answer. Example, growing up my father made us kneel for hours in the garden weeding. He wouldn't let us up until our knees were bleeding. After about 5 or 6 ours we would cut our knees so we could go into the house. Even though that turned into bed with no supper. I couldn't say it then due to fear of a beating. However, out of nowhere I'll come out with "I hate you".
Then, I come back to the moment with having to explain what that was about. You can guess the problem when it happens when my wife and I are alone watching TV. I do know veterans at the VA Hospital that will behave at times like they are still in one of the warsand fight. When they come out of it they know nothing of what happened.
Much is controlled by medication but, if they don't take it, that is when there is a problem. My thoughts are with you and your family.I agree with MG. I also have a councelor at the VA but,my psychiatrist helps with these problems. To tell the truth, I never knew the difference. I thought they were the same. I now know different and suggest try it. We can help with support and encouragement once you find what you're dealing with. Don W

[jazpoppy]

Thanks Don and MG. I am seeing a councelor and have brought the dissassociation problems to my doctor's attention. We are going to look into it. Thanks for sharing your experience strength and hope!

Luv


Jocelyn