recovery group messed me up
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Join Date: Mar 2015
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i'm going to head over to CRI soon, before group this afternoon so i can speak to someone. i'm sliding pretty fast and i don't know how to get a handle on this, i don't feel like i'm in control right now. and it's like the drink is laughing in my face... i know i have a choice so why can't i stop myself? i don't want to end up rattling again and i know i'm heading back there really fast and it's frustrating me to tears. it's frightening. like i get to this point and i know i'm going to drink and i'm battling it so hard and i'm angry and frightened cause i can feel it in every part of my skin like it's grating on my nerves and screaming at me and then it snaps and it's like being dissociated and i'm just an observer in my own body, watching myself leave the house and go to a bar. it's so much like being dissociated co-conscious i'm wondering if i am actually dissociating because i feel like i'm being possessed the same way i get when someone else in my head starts to take control over my behaviour, but i don't want to give away my responsibility for drinking so i'm anxious about exactly what's going on.
it'd be easy to say someone else (or some separate part of my mind) is making the choices for me, and i know ultimately it's all me but if there's a mental health aspect like that then i'm scared that i'm going to be unable to take full control of this. i mean maybe it's AV saying this **** and giving me an excuse to relinquish responsibility but i have to take that into consideration. i've had some severe behaviour alteration due to 'other people' in my head and the catch 22 is that the NHS counsellor i waited six months just to see on a preliminary basis refused to work with me while i was drinking, except my problems with addiction are based in issues for which i need counselling.... and the woman doing my assessment for local rehabs isn't sure any are going to be willing to take on someone with such complex mental health problems because those need addressing and you can't medicate dissociative disorders. they aren't generally equipped, for example, for a situation where i potentially dissociated into an alter who thinks he's five years old and acts as such. which is also incredibly embarrassing for me and probably triggering and uncomfortable for others in the rehab.
i'm on long term disability because of the severity of the dissociation - when it occurs to full extent, i can't function or look after myself. it's relatively manageable with most of the other identity states who are adults but there are a couple of child states and an aggressive teenager that functions as a self-harm role. i know this sounds mental and i'm not really concerned with the mechanics or technicalities of what precisely happens, whether it's actual separate personalities or compartmentalised parts of my mind that have disconnected as a complex coping mechanism (i lean towards the latter, that notwithstanding...) but it puts me in this position where i don't know how to address my addiction.
i want to go to college and get a degree in art and i want to work full time as an artist and make friends, have a relationship with my children and enjoy being alive... go on camping trips and cycle around the countryside and hike on the fells and stay all night under the stars writing, and be ******* normal. i want to be able to look in the mirror. i want to wake up in a clean bed and tidy room that smells like incense and not rotten food and i want hot water and hot meals and a toilet and a house that isn't worse than a squat so i don't have to book a ******* hotel just so i can have a shower, which i did last night after crawling around five different bars and crying into my cocktails. i know these things are simple and achievable and they should be within my grasp. i want it to be as easy as saying just put the drink down. pour it out. be grateful that you have a roof and income, regardless of the source. get up and just do one thing a day even if it's taking a bin out or clearing one of the sides.
so if it's that easy why the **** can't i just do it?
it'd be easy to say someone else (or some separate part of my mind) is making the choices for me, and i know ultimately it's all me but if there's a mental health aspect like that then i'm scared that i'm going to be unable to take full control of this. i mean maybe it's AV saying this **** and giving me an excuse to relinquish responsibility but i have to take that into consideration. i've had some severe behaviour alteration due to 'other people' in my head and the catch 22 is that the NHS counsellor i waited six months just to see on a preliminary basis refused to work with me while i was drinking, except my problems with addiction are based in issues for which i need counselling.... and the woman doing my assessment for local rehabs isn't sure any are going to be willing to take on someone with such complex mental health problems because those need addressing and you can't medicate dissociative disorders. they aren't generally equipped, for example, for a situation where i potentially dissociated into an alter who thinks he's five years old and acts as such. which is also incredibly embarrassing for me and probably triggering and uncomfortable for others in the rehab.
i'm on long term disability because of the severity of the dissociation - when it occurs to full extent, i can't function or look after myself. it's relatively manageable with most of the other identity states who are adults but there are a couple of child states and an aggressive teenager that functions as a self-harm role. i know this sounds mental and i'm not really concerned with the mechanics or technicalities of what precisely happens, whether it's actual separate personalities or compartmentalised parts of my mind that have disconnected as a complex coping mechanism (i lean towards the latter, that notwithstanding...) but it puts me in this position where i don't know how to address my addiction.
i want to go to college and get a degree in art and i want to work full time as an artist and make friends, have a relationship with my children and enjoy being alive... go on camping trips and cycle around the countryside and hike on the fells and stay all night under the stars writing, and be ******* normal. i want to be able to look in the mirror. i want to wake up in a clean bed and tidy room that smells like incense and not rotten food and i want hot water and hot meals and a toilet and a house that isn't worse than a squat so i don't have to book a ******* hotel just so i can have a shower, which i did last night after crawling around five different bars and crying into my cocktails. i know these things are simple and achievable and they should be within my grasp. i want it to be as easy as saying just put the drink down. pour it out. be grateful that you have a roof and income, regardless of the source. get up and just do one thing a day even if it's taking a bin out or clearing one of the sides.
so if it's that easy why the **** can't i just do it?
EndGame
Join Date: Jun 2013
Location: New York, NY
Posts: 4,677
Dissociative disorders are complex and yes, the treatment is often complicated. You would likely benefit from working with someone who has expertise in this area, rather than being assigned to someone in a more or less random manner.
Treatment of Dissociative Disorders
Other than dissociative identity disorder, little has been written about the treatment of the dissociative disorders (Reid, 1989). Apparently, most cases of psychogenic amnesia and fugue resolve themselves spontaneously. Sometimes, the patient recovers his or her memories and identity unaided. In other cases, this process is prompted by contact with family and friends, or by hints generated through free associations or dream reports. Many cases report that recovery was stimulated by the induction of hypnosis, or sedation by means of intravenous barbiturates such as thiopental. However, these reports should be viewed against a background of experimental literature indicating that hypnosis has no special efficacy for the recovery of forgotten, repressed, or dissociated memories (Kihlstrom & Barnhardt, 1992; Kihlstrom & Eich, 1994). Moreover, no clinical or experimental study of barbiturate hypnosis has attempted independent corroboration of the ostensibly recovered memories (Piper, 1993).
Depersonalization symptoms are typically intermittent, but because episodes are often associated with acute mood disorder, and drug treatment for anxiety and/or depression is often recommended. Presumably, benzodiazepines and other psychoactive drugs act on the anxiety and depression in which depersonalization and derealization occur, rather than on the feelings of unreality directly.
With respect to dissociative identity disorder, the traditional approach to the treatment of DID, initially popularized by Thigpen and Cleckley (1957), involves psychodynamic uncovering, abreaction, and working through of the trauma and other conflictual issues presumed to underlie the disorder, followed by an attempt at integrating the personalities into a single identity (Braun, 1986). The cooperation of each personality is required, entailing considerable effort directed toward developing therapeutic alliances. Hypnosis is often used, both for communicating with the personalities and for the integration, which is sometimes performed almost as a ceremony. Of course, psychotherapy does not necessarily stop with fusion: additional time may be required in order to work through the insights achieved earlier in therapy, support the new fusion among the alter egos, and cope with the changes produced by integration.
Even though the modal therapy for DID is insight-oriented, there have been occasional attempts at cognitive-behavioral treatments (e.g., Kirsch & Barton, 1988). Regardless of treatment approach, there appears to be general consensus that the syndrome presents a number of specific challenges to treatment (Reid, 1989), including secondary gain (for the patient, and for the therapist) countertransference reactions of anger, exasperation, and aggression (as well as sexual attraction), suggestibility (especially where the evidence for DID is elicited by hypnosis, without independent corroboration), and the integration of confabulations and other distortions into memory.
As with the other dissociative disorders, there is little in the literature by way of systematic outcome studies (Reid, 1989; Ross, 1997). One exception is report by Coons (1986) on 20 cases; another is the periodic updates by Kluft (e.g., 1988) on a large series of cases. Ross (1997) reported a two-year follow-up of 54 patients (from an original sample of 103): only 12 of these patients had achieved a therapeutic goal of stable integration, although the group as a whole reported diminished levels of dissociative experiences. Still, as Ross (1997) notes, Astrictly speaking, there are no treatment outcome data for dissociative identity disorder in the literature@ (p. 247). Given all the attention that DID, has received since 1980, and the fact that whole units, if not entire hospitals, have been developed for its treatment, with the ensuing claims for out-of-pocket and third-party payment, this situation is remarkable and deplorable.
Most current treatments of DID appear to be predicated on the notion that the syndrome is caused by childhood trauma such as sexual and physical abuse (Horevitz & Loewenstein, 1994; Ross, 1997). Thus, after the patient has been stabilized, Kluft (1993) recommends a focus on the uncovering and resolving trauma and the abandonment of dissociative defenses. This recommendation would make no sense if there were not memories of trauma to be uncovered and dissociative defenses against such memories to be eliminated. However, as noted earlier, it is not at all clear that the origins of dissociative identity disorder lie in sexual abuse or any other form of childhood trauma. In the absence of convincing prospective evidence that DID has its origins in childhood trauma, such a post-centered focus seems premature at best, and at worst raises the possibility that false memories of childhood sexual abuse may be constructed during the course of treatment. Return to index.
Treatment of Dissociative Disorders
Other than dissociative identity disorder, little has been written about the treatment of the dissociative disorders (Reid, 1989). Apparently, most cases of psychogenic amnesia and fugue resolve themselves spontaneously. Sometimes, the patient recovers his or her memories and identity unaided. In other cases, this process is prompted by contact with family and friends, or by hints generated through free associations or dream reports. Many cases report that recovery was stimulated by the induction of hypnosis, or sedation by means of intravenous barbiturates such as thiopental. However, these reports should be viewed against a background of experimental literature indicating that hypnosis has no special efficacy for the recovery of forgotten, repressed, or dissociated memories (Kihlstrom & Barnhardt, 1992; Kihlstrom & Eich, 1994). Moreover, no clinical or experimental study of barbiturate hypnosis has attempted independent corroboration of the ostensibly recovered memories (Piper, 1993).
Depersonalization symptoms are typically intermittent, but because episodes are often associated with acute mood disorder, and drug treatment for anxiety and/or depression is often recommended. Presumably, benzodiazepines and other psychoactive drugs act on the anxiety and depression in which depersonalization and derealization occur, rather than on the feelings of unreality directly.
With respect to dissociative identity disorder, the traditional approach to the treatment of DID, initially popularized by Thigpen and Cleckley (1957), involves psychodynamic uncovering, abreaction, and working through of the trauma and other conflictual issues presumed to underlie the disorder, followed by an attempt at integrating the personalities into a single identity (Braun, 1986). The cooperation of each personality is required, entailing considerable effort directed toward developing therapeutic alliances. Hypnosis is often used, both for communicating with the personalities and for the integration, which is sometimes performed almost as a ceremony. Of course, psychotherapy does not necessarily stop with fusion: additional time may be required in order to work through the insights achieved earlier in therapy, support the new fusion among the alter egos, and cope with the changes produced by integration.
Even though the modal therapy for DID is insight-oriented, there have been occasional attempts at cognitive-behavioral treatments (e.g., Kirsch & Barton, 1988). Regardless of treatment approach, there appears to be general consensus that the syndrome presents a number of specific challenges to treatment (Reid, 1989), including secondary gain (for the patient, and for the therapist) countertransference reactions of anger, exasperation, and aggression (as well as sexual attraction), suggestibility (especially where the evidence for DID is elicited by hypnosis, without independent corroboration), and the integration of confabulations and other distortions into memory.
As with the other dissociative disorders, there is little in the literature by way of systematic outcome studies (Reid, 1989; Ross, 1997). One exception is report by Coons (1986) on 20 cases; another is the periodic updates by Kluft (e.g., 1988) on a large series of cases. Ross (1997) reported a two-year follow-up of 54 patients (from an original sample of 103): only 12 of these patients had achieved a therapeutic goal of stable integration, although the group as a whole reported diminished levels of dissociative experiences. Still, as Ross (1997) notes, Astrictly speaking, there are no treatment outcome data for dissociative identity disorder in the literature@ (p. 247). Given all the attention that DID, has received since 1980, and the fact that whole units, if not entire hospitals, have been developed for its treatment, with the ensuing claims for out-of-pocket and third-party payment, this situation is remarkable and deplorable.
Most current treatments of DID appear to be predicated on the notion that the syndrome is caused by childhood trauma such as sexual and physical abuse (Horevitz & Loewenstein, 1994; Ross, 1997). Thus, after the patient has been stabilized, Kluft (1993) recommends a focus on the uncovering and resolving trauma and the abandonment of dissociative defenses. This recommendation would make no sense if there were not memories of trauma to be uncovered and dissociative defenses against such memories to be eliminated. However, as noted earlier, it is not at all clear that the origins of dissociative identity disorder lie in sexual abuse or any other form of childhood trauma. In the absence of convincing prospective evidence that DID has its origins in childhood trauma, such a post-centered focus seems premature at best, and at worst raises the possibility that false memories of childhood sexual abuse may be constructed during the course of treatment. Return to index.
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Thread Starter
Join Date: Mar 2015
Posts: 133
thanks for the info endgame. I've looked into various treatments for DID and other dissociative disorders; there are few people within the NHS at least locally who have any experience working with DID and the symptoms generally get dismissed as either psychosis or brushed into the BPD category, hence my previous working diagnosis of schizophrenia. The NHS mental health care is extremely limited and therapy waiting lists are upwards of six months to over a year. I've been able to have a brief discussion with a psychologist who was unwilling to work with me before I went into detox, though I might be back at the bottom of the referral list again – it was over six months before I could see her for the preliminary appointment, though while discussing her with my care coordinator, I was made aware that NHS psychologists (or at least her...) aren't prepared to work with people who are unstable and that she wasn't able to offer me any therapy until it was ascertained who exactly was the 'main' persona as she could only work with a specific individual rather than anyone who might be switching between personalities, and definitely not if I was switching to a child state... which I thought was ridiculous given that when I switch I have no control and I've lived as varying different people at different stages of my life all of whom believed they were the 'main' personality.
This is what I'm stuck with as private psychologists/psychiatrists, who are generally the only people who seem to have any experience with complex dissociative disorders, cost an immense amount of money, and I couldn't even afford to continue seeing the private counsellor who I spoke to for a few weeks. Any of the available therapies that are recommended for DID are limited to private therapists. No one I have spoken to within the NHS has a single clue about how to approach my symptoms except attempting to throw a cabinet of medication at me. I've tried a great deal of anti-psychotics, anti-depressants and anxiety meds and none have mitigated the dissociation, delusions, behaviour alteration, auditory and tactile hallucinations, depersonalisation, intrusive thoughts and feelings or the flashbacks. I'm aware of false memory syndrome but I've never had any therapy attempting to uncover hidden memories; the childhood flashbacks I've experienced have occurred without specific prompt.
I went to the CRI as I said I would before the Monday afternoon group and spoke to the group facilitators but I ended up dissociating worse than I have in a long time. Saw my OT in a very dissociated state and wasn't able to communicate in much more than monosyllables. She said she hadn't seen me this bad in months... I don't remember what happened after that. Don't think I drank anything between Sunday night and now but I've been slowly working my way through a bottle of wine over the past few hours... feels kinda pointless since I can't feel a ******* thing. Except that I'm tired.
A couple of months ago when I was still talking to my ex... when I was drunk out of my mind and rattling really bad... I tried to come out as gay. She was the only person I talked to about it and probably not the best target for divulging something like that but I got knocked back pretty good by her response... like I've been 'unofficially' bi for a long time but it was more of an extended 'this is scaring the **** outta me' half admittance of who I really am, but it's like I don't know where I stand because of the dissociation, and with my addictions and my lifestyle and the way I've managed to destroy all of my relationships, I keep avoiding it. I don't know what's the cause of what any more. If I'm an addict because of my mental health problems and if they're caused by my childhood or if I'm ****** up because of my sexuality or if that's a by-product of the dissociation or if I'm looking for ways of avoiding coming to terms with it, and working out how stop hating myself so much seems like an insurmountable task. I feel completely ******* alone.
This is what I'm stuck with as private psychologists/psychiatrists, who are generally the only people who seem to have any experience with complex dissociative disorders, cost an immense amount of money, and I couldn't even afford to continue seeing the private counsellor who I spoke to for a few weeks. Any of the available therapies that are recommended for DID are limited to private therapists. No one I have spoken to within the NHS has a single clue about how to approach my symptoms except attempting to throw a cabinet of medication at me. I've tried a great deal of anti-psychotics, anti-depressants and anxiety meds and none have mitigated the dissociation, delusions, behaviour alteration, auditory and tactile hallucinations, depersonalisation, intrusive thoughts and feelings or the flashbacks. I'm aware of false memory syndrome but I've never had any therapy attempting to uncover hidden memories; the childhood flashbacks I've experienced have occurred without specific prompt.
I went to the CRI as I said I would before the Monday afternoon group and spoke to the group facilitators but I ended up dissociating worse than I have in a long time. Saw my OT in a very dissociated state and wasn't able to communicate in much more than monosyllables. She said she hadn't seen me this bad in months... I don't remember what happened after that. Don't think I drank anything between Sunday night and now but I've been slowly working my way through a bottle of wine over the past few hours... feels kinda pointless since I can't feel a ******* thing. Except that I'm tired.
A couple of months ago when I was still talking to my ex... when I was drunk out of my mind and rattling really bad... I tried to come out as gay. She was the only person I talked to about it and probably not the best target for divulging something like that but I got knocked back pretty good by her response... like I've been 'unofficially' bi for a long time but it was more of an extended 'this is scaring the **** outta me' half admittance of who I really am, but it's like I don't know where I stand because of the dissociation, and with my addictions and my lifestyle and the way I've managed to destroy all of my relationships, I keep avoiding it. I don't know what's the cause of what any more. If I'm an addict because of my mental health problems and if they're caused by my childhood or if I'm ****** up because of my sexuality or if that's a by-product of the dissociation or if I'm looking for ways of avoiding coming to terms with it, and working out how stop hating myself so much seems like an insurmountable task. I feel completely ******* alone.
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Join Date: Jan 2012
Location: West Tn
Posts: 3,043
Take heart, Lycanlaz, many of us folks in recovery were, at least early on, an untreated "mixed bag" of mental and nervous issues.
I don't understand a lot of the acronyms you and others use, like DID (I gather the 2 D's are Dissassociative and Disorder, but I don't know what the "I" is), CRI, CRT, NHS, etc.
But I do know what it is like to be overwhelmed, confused and hurting.
Help was out there for me, and I suspect it is for you also.
Thanks for your posts.
I don't understand a lot of the acronyms you and others use, like DID (I gather the 2 D's are Dissassociative and Disorder, but I don't know what the "I" is), CRI, CRT, NHS, etc.
But I do know what it is like to be overwhelmed, confused and hurting.
Help was out there for me, and I suspect it is for you also.
Thanks for your posts.
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