Brief Cohesion

My time in the hospital has been marked, so far, by an unbelievable lack of internal cohesion and a nearly constant state of internal fragmentation. For the five plus days here, I have been all over the dissociative map, spending hours upon hours sitting out in front of the "safe" Nurses' Station, using my basic set of learned grounding skills along with the few other patients who also are at various states away from ground. I try not to judge too harshly my needing to do these basic grounding skills. I know the judgements do not solve anything. I use the iPhone games quite a bit, sticking to ones that are most helpful when dissociative: Peggle, Cross me Not, Cross Fingers, and MLB Baseball. I have listened to a little bit of classical music. I write. I draw. I talk. I don't sleep much. I try to participate in groups, but it has been really difficult for me this time.

There are some pressing issues here. The first is eating. I know eating is a form of control. I also know that it was hugely prominent back in the 90s and has been brewing for a while now. I am now at a 20 pound weight loss over the past couple months. And the hospital has exacerbated this issue. With DID, though, it's not uncommon to be in a part of yourself who has no trouble eating. But this often triggers parts of the system who do have these problems, makes them feel out of control, and the result is almost always more dissociation (and more trips to the Nurses' Station). Usually, I find that my best bet is to eat when I am able to maintain somewhat of a sense of core control, make negotiations, eat very small portions in a very deliberate manner, and all the while respect the difficulties that parts of me have.

Other parts have trouble with physical pain and it is severe enough to necessitate narcotic pain medications at times. The pain is always much worse in the hospital. It is always perceived as a complex of body memories. But maybe that is too easy an explanation. Medications are a bit tricky. There are two sides. I cannot rely on the medications as a first response, because they remove my first obligation to attempt to utilize the grounding skills (and may become a crutch). On the other hand, sometimes the grounding skills simply will not yield relief and at a certain point my doctor says, "There is no purpose in being a Marine when dealing with this". So the medication certainly can play a role; although my response to pain medications varies widely.

Yesterday, Monday, was almost totally lost time and this has been par for the course. My journal entry from 4:55PM reads:

In a short span, by 7PM, there was a sea change. I knew what this meant; that I was on the fast track to leaving the hospital. It is hard not to like me this way. I immediately developed a sense of humor, ironically made jokes about eating (there is a nurse who loves to talk about food), felt super strong and confident, and ultra-grounded. Usually I then quickly begin to get irritated about being here, and do nothing but advocate for leaving.

But I made an agreement when I first came in. It is documented in my private journal. I came in because I went into a functional state, denied parts, and kept pushing onward. I did not go into denial about parts consciously over the past few months. I did it for survival in order to achieve life tasks that needed to be done (e.g., work and home). To achieve this level of functionality, I sometimes have to do the equivalent of putting all the parts in a virtual "dungeon". In fact, often my perception is that parts cease to exist.

When I came in here, I said I cannot use the same tactics I generally use in the hospital, where I get recharged some, reconstitute myself, and leave. I know I will end up going back to the same life-threatening safety issues that are front and center in my life right now. The part of me who is focused on the serious self-harming needs to be addressed and the work needs to start in the hospital. This kind of work with similar acting out parts in the past all began in the hospital. I understand this part needs to be communicated with if I am to achieve any sense of real safety and stability at home.

So, I quickly became determined not to let this new "awakening" get in the way of what I knew I must do. The "awakening", though, felt amazingly good, but it was not long before everything started shifting yet again. By 8PM, I started to act out the normal script; I have been in the hospital too many times to not see it. Oh, there was a temptation to keep telling staff "Things are fine, I feel great, I'm okay." I started to do some of that. But this is not a game, and this is life and death serious. I was up front with them. When I tell that them that I know there is more to what is going on right in the moment, they get it. When I tell that that my safety has been off-scale jeopardized and life-threatening, they get it. When I tell them that I do not have any evidence at all that the motivations of this dangerous part have changed one bit, they get it. The nurse said (paraphrasing): "Not to worry; we will not let you go until the big safety issue is addressed head on."

At 10:28PM, the steps I had taken had again changed things inside. The cohesion started lessening and I wrote in my private journal:

At 10:40PM, I wrote:

Tonight, I slept for a mere 1.5 hours and was not phased by the second round of sleep medications. I do not know where all this will take me. Doctors, nurses, and friends are basically telling me to "keep working and see what happens". I am working super hard. I am being given time and space. For that I am grateful and determined.

You may be interested in these related posts:

• Mental States (May 2009; visually represents different mental states)
• Awakenings: An Extreme Example (September 2009; discusses an experience similar to the "awakening" discussed above)
• Making Sense of Nonsense (December 2009; talks about what led to the place I'm at now)

 Printable PDF