Recently in Dissociation Category

I have hurt myself, sometimes quite seriously, many times. It is difficult to rank serious self-harm and suicidal events because one must take into account both the physical and psychological damage. But while there is a good deal of subjectivity involved, there is no question that what I did to myself last week ranks up there as among the most serious in my lifetime.

Physical damage is what most use to rank such events because it is quantifiable. Like many others, I have taken dozens of overdoses over the years. Two of them were clearly different from all the rest. They were the ones which were especially calculated. They involved taking many times the lethal dose. And they were preceded by taking sedatives so that I would not be able to change my mind and go to anyone for help afterwards. Those were obviously serious physically and I was lucky to have survived them many years ago.

Hurting myself in the present often involves recreating the past by finding others to hurt me, either virtually or in real-life. This has gone on for years, is often an instinctive response, and is something I am ashamed of. It has been damaging because I have perpetuated the abuse done to me and has led to all sorts of problems. What makes it difficult is that most of the problems are psychological and comparatively easier to hide.

As I have healed, the more I appreciate the extent of the psychological damage of this kind of self harm. To put it into some context, long ago when parts of me were much more separated, these self harm events were more isolated. While it undoubtedly caused psychological damage, those hurt parts had little or no understanding of where their distress was coming from.

Without question, increased awareness and internal communication—whether one has dissociated identities or not—are necessary components to healing and tools to help keep us safe. But there are no guarantees of safety. When safety is breached, the increased awareness leads to a totally different perspective of the effects of this type of self abuse.

What happened last week was arguably, for me by my own scale, the most serious event of its kind ever by many measures. To call it self harm or self abuse is not even adequate. Self harm was the terminology I used a decade ago. Self abuse was the terminology I began using a few years ago. What happened last week was a psychological suicide attempt. I think it is important for me to be as precise as possible and not cloak what happened with more polite terminology.

A couple days ago, I did an analysis of both the events and feelings which has led me to label what happened in such a unambiguous way. While a lot of the actual events are lost or in flashes, I have enough information to know that what happened was in a totally different class from past events. I also have hard data. I had numerous entries in my private journal, text messages, and phone logs in the hours leading up to what happened. I have a perspective that is much clearer than any similar event before.

But the saddest piece comes not from the actual harmful events. Not from what was done to my body or done to my psyche.

The plan from the night before was to be admitted to the hospital, where I am now. I had become too unstable, too fragmented, and too much at risk. I told my therapist I needed some time to tie up some loose ends at work and do some last minute preparations. I was to be in hospital admissions by 6PM. That was the agreement I made.

It turned out that I was not grounded enough to be trusted with such an agreement or such an amount of time on my own.

I know there was internal conflict about getting hurt that day. That conflict usually is what keeps me safe. But there was very little sense of reality and no sense of ground. And, so, "safety" and "getting hurt" existed as their own isolated parallel threads. That dynamic of polar opposites existing simultaneously increased the safety risk manyfold.

At one point, I was at a tibetan arts store to get my wife, who is into yoga, a Christmas gift. Amidst all the confusion and fragmentation, at 1:45PM I wrote these words in my journal: "Healing. Went to the tibetan store for a present. Big shift now towards safety. But confusion and conflict too." That nearly led to a change of course to not get hurt. But it was not enough.

At the store, I also searched for a gift for my therapist. I thoroughly explored the shop and what I found for her was a compassion stone. It is a small stone from India with the "Om mani padme hum" mantra on compassion in Tibetan script . This is sad because it is proof that there were enormous coexisting efforts to be safe and also to be hurt.

While it certainly feels like my "gift" to my therapist is tainted, I hope we can take from this something positive.

This stone, then, obviously has critical significance. It perhaps should sit in my therapist's office, or be accessible to us. We should use it as a reminder of how the desperate effort to be safe and compassionate was destroyed—within minutes.

For me, that stone will probably be my most important icon in the world. It is something tangible from that horrible day. It will mean more to me than the medical records I have from the major overdoses. More than poems I have written from long ago about sad events and abuse. More than any art work I have made. Even more than records I have from the Catholic Church.

That stone represents the fact that I made a choice. That stone embodied all of my hope. It embodied all of my compassion. And I, and I alone, made the choice to destroy all of that.

I will never forget that.

And now I have to pick up the pieces and recreate what I have destroyed.

All of us live in a world of cycles.

Cycles, I think, are meant to be double-edged swords. They are the necessary friction of life that I have talked about before.

In the best of cases, we use these predictable cycles as a means of helping us navigate through the phases of our lives. Many of us probably recognize how these are sometimes referred: familiarity, teachable moments, evolution, wisdom, maturity.

We are probably all aware of how a new cycle can serve as a clean slate. When I was in school, every September I was fond of saying "I don't have a single poor grade!" Or, we are probably also aware of a sense of comfort in what is familiar. Every Spring is a time of renewal. Most every Christmas has been a time of magical wonder. I live in an area of the world that snows right around Christmas-time and that serves as a metaphorical punctuation mark.

But, anniversaries of traumatic events and triggers are also types of cycles. And therein lies the friction. And the dichotomy.

Speaking for myself, I know I can very easily find myself trapped in a new cycle and have little or no perspective on it. In other words, the cycle can be strictly seen from a historical point of view. In still other words, parts of me can be stuck in the past.

I so dislike admitting that. I would rather believe that I am full of awareness and am fully healed and fully safe. Period.

But that is simply not true.

For those of us who have lived many years using dissociation as a core means of coping or navigating through cycles or triggers of past trauma, this is not really difficult to fathom.

I have not written here in over a month, and during that time I have experienced many triggers and not navigated all of them well. Just ticking off some of the highlights, there was the perennial Halloween "holiday", with all its normally charged associations, plus we had a rare crippling snowstorm. Then the relentless news of the US college sports sex abuse scandals, which have rocked me to my core. It was not really much of a surprise, but I was caught unprepared by the impact of the late November "anniversaries" of major suicide attempts from the early 90s and the connections to where I was last year (in the hospital). Finally, "church abuse" news, direct or indirect, seems to always crop up.

Reflecting on the past month or two—I have lost track—I can easily say life has been more tilted towards disconnection and chaos and "living in the past" than it has been towards awareness and looking towards the future. My life has certainly not been in any sort of balance, and I have not been safe from purposely hurting myself. As a result, life has become extremely distorted and unstable, and what feels safe also does not feel safe, sometimes simultaneously. Some of you know will know what that statement really means.

I have been living precariously. There has been a thin line separating life and death, connection and disconnection, giving up and holding onto hope.

What is most scary, is that I do not even think I realized this!

But this afternoon, the seas have calmed. The compass appears to be working. The ship's wheel isn't spinning out of control anymore. The ship is moving forward. With direction. With purpose. I can see land.

Despite what our psychological "clocks" tell us, we arrive at a new cycle, but always at a place in time that is ahead of the last one. We may not appreciate that as a statement of fact in our times of struggle. But it is a fact. No matter how "in the past" parts of us may be, I strongly believe that we are destined to heal, to find balance, to learn from our past, to build a better future.

A note about the 'Expressive Arts Carnival.' I am sorry for the break in routine, but the carnival will be back with new activities next month.

This is the first photograph of mine that I posted here over 2 years ago. When pondering about what I would share as my "Hopes and Dreams" for this month's arts carnival, I thought about doing something new and creative. But this image captures the essence better than any other. So, I thought I would come back to it, but write about it in the present.

At the time I made this photograph, I was blossoming in terms of my commitment to external and internal awareness. Prior to this time, I had focused almost exclusively on intellectual understanding of my problems. And while that pursuit yielded good results, there was something missing and it was not enough. I quickly an important lesson: that the most healing comes from a balance between intellectual understanding and exploration on the one hand and emotional understanding and exploration on the other.

The context for this image is that "becoming one," or to use the common term of "integrating," had dominated my thinking for many years. That was my clear goal—or hope or dream—for so long. I finally realized that, for me, that set up an unresolved series of internal tensions. Becoming "one," in a strict sense, is not who I am. It never was. So, I said to myself: "Why make a goal for myself something that is not who I am?"

I now do not see integration as a goal. Rather I see as a goal for me a fluid collaboration based on mutual respect and understanding. In this view, there is more flexibility. Parts of me have the opportunity to flourish and be laser-focused if they need to be or work together with other parts of me to accomplish what we cannot separately.

Having somewhat separate parts of my personality is not the major problem facing me. It is having parts and not being able to be safe that is the problem. Or having parts and having there be no communication or collaboration, thereby rendering them fully isolated. I cherish my ability to be able to accomplish goals in life that I know are borne from my parts-based system; goals that I feel might not be possible without such a system.

So, the question for me has always been how to maintain safety and at the same time cultivate collaborations and communication leading to a more fluid existence? That is what this photograph represents. I had thought "becoming one" would automatically lead to safety and was the ultimate answer. But in many ways I believe that to be a draconian solution, and not even the best solution. I also thought it would someday just happen. After all, I have read stories of how others "integrated" and how it can happen very quickly.

The truth is, while I am not at all glorifying dissociative identities, I could not ever imagine such a solution for me. The more and more I get to know parts of me, the more I appreciate who they are, what they represent, and appreciate their own individual hopes and dreams and hurts and desires.

This photograph can be seen as "one." It is one wall after all. But it is made up of many pieces. On one scale, all parts of me can be seen as one, and this is how most people in my life see me and this is what I want most people to see. It is absolutely true that together we make up one person. One system. But I also acknowledge that the parts of my psyche are not just aspects of one personality. They are more separate, and I accept that.

And it is through that acceptance that I have learned to move towards a more balanced existence.

In my post from over two years ago, I wrote:

So, my hope and dream is for my life to be more representative of this image. That there be collaboration. That parts support other parts. That when viewed on a macro scale it appears as one. But on the micro scale it appears as many. That each part is different yet has similarities to others. And so on.

For those of you who have not submitted an entry for this month's Arts Carnival, submissions are extended through the end of September 27th (EST). I will publish on the 28th.

There are endless comparisons one can make between failures in technology and psychological "failures." I will not bore you with very many examples, but I have seen quite a few error messages in my day from the computer side, mostly stemming from memory issues. "Segmentation fault", "Stack overflow", and "HeapDumpOnOutOfMemoryError" are just a few. "Core dump" is a common Unix error that can be a bit intimidating, especially if it is on a computer mainframe that hundreds of users depend on. One of the more scarier messages came from the old Mac computers. Imagine a window popping up with a clip-art image of a bomb. Yes, Steve Jobs and Steve Wozniak envisioned what has become arguably the slickest computer operating system ever created. But back in the day, you got a bomb along with a message that said "Sorry" and a frozen computer.

Computer memory is made up of individual bits that are either zero or one. What could be easier than that? Sure there's quite a lot of physics in there, but memory storage is conceptually simple. Of course, the computer needs more than one bit. Modern computers have many gigabytes of memory. 16GB of memory is also 138 billion bits of information. To give some perspective, that number is about 20 times the entire current population on earth or roughly equivalent to the number of human beings who have ever been born! All those pieces on one little laptop running a Web browser and Word!

What makes memory complicated is that there are management techniques that programmers must take into account in their programming. Every time a programmer creates an object in their code, they are asking the computer to assign memory for that task. Programmers have to know things like how much memory to allocate, whether their code is causing a memory leak, and sometimes when to dump memory. There are also tools that the tech-savvy among us can use to analyze the state of the memory.

Of course, many times memory errors cause a total system failure, sometimes known as a "kernel panic." The computer will hang and you have to restart it, fix it or in some cases throw it away and get a new one.

The reason why I bring up memory errors is that I have been having a lot of them lately. I wrote not even a week ago about the firm ground I found myself on. A lot fell into place for me. I had crystal clear perspective and was able to look at my life at any scale, from the big picture to all the small details. That firm ground lasted for what felt like a microsecond, but was actually about a day. It is almost impossible for me to believe now that only a few days have passed. Over the past week, I have been writing in my journal about the enormous swings of knowing and not knowing, connection and disconnection, wonderful tingly sensations and searing pain.

I have often seen the ability to attain what feels like a internal wholeness, with accompanying clear sense of safety, as touchstones or experiences to strive to achieve more regularly and for longer periods of time. They have been motivators.

But this week has not been like it has been in the past. This week I am hugely discouraged. I have lost hope. I am angry. I am checking my calendar and journal constantly, looking back on what I did and only vaguely able to make sense of it. But my problems are more than just a memory errors.

To continue the computer metaphor, memory, along with other layers of computer architecture, are managed by the operating system. I can easily think of myself as an operating system. My treaters are encouraging me to enlist others (inside) for help, saying I cannot do it all alone. But that kind of advice is really falling on deaf ears. As I have told them: "I know that, but I can't do that." Or, more precisely, "I know that, but I can only do it for very brief periods."

I also know I have a responsibility for safety, and that complicates everything. Safety was severely compromised last month and I am in many ways still reeling from that. Sharing responsibility, for me, means that I must put myself in a more vulnerable position. When I allow parts of me to come forward, so to speak, I put a lot on the line. I know full well that many parts of me do not worry at all, or even know much at all, about safety issues.

I now find myself in a huge bind. I have a wealth of experience that tells me that collaboration and communication internally lead to more wholeness and fluidity of experience. I know that I do not have enough resources to manage my life without the contributions of all parts of me. But I cannot do what is needed without internal trust. Because of the safety breach, that trust is simply not there now. I simply cannot take that risk. Yet I do not feel any safer.

So, I am doing exactly what a computer operating system would do.

A "kernel panic."

Image is from Dmitry Vostokov's Dump Analysis blog, who has many very amazing visualizations of memory. Click on the "Art" category.

I know it has been a long while since I have written here and an even longer time since I have been reading other's blogs or in touch with friends both in my healing circle as well as other areas of my life. I have been basically out of it on so many levels, including internally, but still able to present a front of super functionality. After several months of this, I finally feel like I have found some stability. I learned a lot and I write more specifically about it soon.

Today, though, I want to make my contribution to this month's Expressive Arts Carnival. In the announcement for the Carnival, I did not say that I did this exercise before, a bit over a year ago while inpatient.

In thinking about this directive now and who I could possibly write about who has taught me, my thoughts go inside of me. I have learned the most about healing from me. That may sound like a "big ego" statement. But it is more a statement about acceptance of parts and an understanding that dissociated identities is fundamental to who I am.

I know I have talked about this many times before: When I get into a denial space internally and make statements that parts of me do not exist in the very separate way they do, I end up not being true to myself. And that truth is a necessity. That is what I have been missing over the last few, at least, months.

A good deal of healing comes from communicating with discrete parts. Of course, they are all connected and we are one person. But it is also true that I have evolved in a very compartmentalized way, and so learning about those compartments and building connections is what a lot of my healing journey is about.

Over the past few days, since I have found a sense of balance, the key thing I have done was to accept and listen inside. I stopped pushing parts of me away. I acknowledged all of them. That approach has changed everything for me. No longer am I so confused. No longer am I losing time. No longer am I so hugely distant from memories that I just pushed away. No longer do I have no understanding for my behavior, and why I was driven to self-harm.

Indeed, the past few days have been humbling for me. I now know that "I" is broad. I am more than "I" and that is something I must accept. It makes the journey more simpler in some ways (e.g., I gain more fluidity) and also more complicated in others (e.g., I have to own difficult feelings). But that is my reality. My path. And I am back on it.

My words for the Carnival are: Truth, Healing, Balance. And my hex color code is #855E42 (named "Dark Wood," which for me signifies being grounded like a tree).

The Carnival will be published tomorrow, on the last day of the month. If you want to make a last minute entry, please do so by 2PM EST July 31 and I will include it.

At this time last year, and the year before, I was in the midst of "internal disconnection." The same is true this year. And the same has been true at other times. I have always come to the conclusion that I am not well served when I am disconnected, and I have often spoke of how it leads to issues of safety. Disconnection is not consistent with my present-day philosophy on how I want to live my life and my direction in healing. But I am often at al loss for how to fix it.

Part of the issue maybe many of you will identify with, is that for parents, June is a really rough time of year. The school year ends in mid-June and there are a bevy of school-related activities. If you are an involved in helping in the schools, and I am, it can feel like a bit too much. There are concerts, field days, field trips, end-of-year PTO meetings, and the list goes on and on.

And, added to that is another ever-present issue: change. As I have worked on healing, I have become more aware of how I am affected by what is around me (events and people). No school for the kids means quite a drastic change. Seasonal change, especially in New England, is always dramatic. The weather also shifts from downright cold to hot. Work is in flux with colleagues vacation schedules; plus being in academia, summer is quite different.

No wonder all of this throws me (and probably you too). I often get thrown a lot. I feel like I am not very versatile anymore. What I used to handle purely by dissociating, now often feels terribly complicated. Nothing ever seems simple anymore.

But, over the years I have developed some "go to" skills. When I feel out of balance, like I do now, it is a reminder to go back to these basics.

The basics may appear on the surface to be quite simple, but they are often not at all easy to do (and are often easy to ignore). For me, though, the "nuts and bolts" are rather clear:

• Take time to self-reflect; and don't have therapy be the only time you practice this. My journal writing has mainly been reporting and very "diary like." I have used my journal in more substantial ways in the past, which means as an adjunct to therapy where I make sense of reactions and experiences.

• Practice mindfulness. This means actively paying attention to what the experiences are while you are going through life. If I am mowing the lawn, it helps to go slowly and appreciate what I am doing. If I am planting in the gardens, it helps to feel the soil and draw parallels to internal growth.

• Self-care needs to be often and regular. This means finding ways to get meaningful and consistent sleep, taking care of pain issues by self-soothing, and eating. It means also taking time to play (with the kids), not only being "in your head" and using music (playing or listening) as a healing tool.

• Art. Drawing and art making (including photography) is another tool I have used to give me access to feelings, which do not seem all that accessible right now. I often have resistance to doing art. And I often find that I will reconnect in this area by increasing my use of photography (which is happening now, so that is a positive).

If I thought more carefully, I probably could come up with a longer list. But these are the main areas that come to mind based on my experience.

My immediate reaction to these are: "OK, Paul, easy to say but hard to do." One could then say that the list is trite. Way too simple.

That thinking, however, is merely a trap.

I have often spoke of simple solutions. A dissociative mind by nature is a very complicated mind. In many ways I think we get accustomed to this. I have used metaphors in the past of the complexity of an orchestra leading to beautiful and harmonious music. I have spoken about sports teams and various specific roles each athlete has and how they can come together for one goal.

An attempt at simplifying is not at all to invalidate real difficulties. Rather simplifying and practicing the "nuts and bolts" helps deal with the complexity.

This is my contract with myself, my agenda if you will for the coming weeks.

Dissociative identity disorder (DID) has, for decades, been described in terms of a prototype model which has roots in being called multiple personality disorder. Recent years has seen a realization that dissociation, including more intense dissociation seen in DID or DDNOS, is experienced in a myriad of different ways for different people and at different times.

However, I am not at all convinced that this realization is widely embraced. Clinicians not exposed to many cases of more extreme dissociation or those who try to grasp what dissociation is without prior experience, including those who are newly diagnosed, are often hard pressed to think outside the prototype. While the television series United States of Tara, for example, captures a good deal of what the experience can be of dissociation and switching, it also goes a long way towards reinforcing the well-defined prototype.

I have seen so many, including myself, get caught up in what the DID prototype says we are supposed to be like. That can be a real barrier to healing. It encourages us to deny those experiences that do not fit the prototype and accept those experiences that do fit. That is not to say that we do not have experiences that conform nicely to the prototype. I have seen, and experienced, florid DID which is much like the prototype of Part A knowing nothing about Part B, with self-destructive acting out. DID can really be out of control, but most of the time DID is not like that for most people. And, so, I think it is important to look at all of this from a broader perspective (i.e., that those of us with DID or DDNOS are much more than simply our disorders).

For those of us who experience a wide range of dissociation, we know that the prototype is mostly feature driven and, as such, somewhat superficial. Massive identity shifts are often responses to stress or a trigger. Everyone has reactions to stress and everyone has triggers. With large dissociative walls, our reactions simply tend to be more extreme than most, but they are fundamentally based on the same principles. Complicating matters is that anxiety associated with switching is usually self-perpetuating. Often there is an resulting panic when we realize that we have not been in control of what our body has been doing or have lost time.

In order to heal, our focus needs to become internal and personal. We have to realize that the task is to identify and come to terms with our myriad internal conflicts. When we do that, we are not focusing on the prototype, but rather our own unique experiences and feelings. That is how the barriers can come down, how communication can commence, and how collaborations can ensue. When that happens our experiences become richer. We become more aware. My increased awareness changed everything for me. In many ways it is not even easier, but much harder. I sometimes liked it better when I was not as "co-conscious", when I could just slip away and let someone else take over. Now I am somewhere in between, trying to find my way to a place of healing.

I see DID as a complex network, one that has features of the prototype (parts with rigid barriers), but also has fluidity that allows for barriers to come down and parts to interact in a seamless, dare I say completely normal, way. I have often represented this visually, with parts as circles and lines connecting them. I try to show the reality that the system is not static. That we are not locked into a prototype. That the barriers can come down, but that they can go back up too, and come to some appreciation that DID is really about how we interact with ourselves, no matter how "unconventional" it may seem on the outside.

While DID is unquestionably very challenging, I think it helps to place it in some context. There are far more complex systems on different scales. DID for an individual can be seen as simpler, than say, the community in which you live. Or world governments. Or ecosystems. Or the network of neurons in our brains. Or online social networks. I am constantly trying to reality check my experience of DID with the complexities I know exist in the world. When I am able to do that, my struggles become a bit easier to cope with.

I am not saying that DID is normal. Far from it. But I am saying that when we look at it in a wider context, we make it much easier for us to heal.

In my last post, I wrote about the language of dissociation, specifically focusing on the issue of names in dissociative identity disorder (DID). That discussion leads me to the issue of language while maintaining healthy personal and public boundaries.

Many years ago, I decided that therapy and the hospital would be the places where I would trust and talk freely about all of myself using whatever language and techniques worked best for me. I decided, and a lot of this was a decision driven by instinct, that when I write publicly and interact with people in my life—including most family and friends—I would be extremely careful about the language I chose to use.

I try to write and communicate with others in such a way that it can broadly make sense. I find one important way to destigmatize trauma recovery is to not use language that makes the issue esoteric or unique. I avoid altogether talking publicly, except here and with family, about dissociation. I find it makes me feel safer and less exposed. I have come to terms with the reality that Dissociative Identity Disorder will probably never be something that any significant numbers of people will understand or accept without judgment. It will never be seen like cancer and probably never be seen like depression. It will be so strongly stereotyped because so few have direct contact with it. I have no problem with that.

One of the reasons why I started this blog was that I came out publicly when a child sex abuse scandal in our town came to light. I spoke out in the newspaper and as a parent in the community about the issue and came forward as a survivor myself. I did that to lend some credibility to my argument, saying that we all needed to make sure that we appreciate and attend to the plight of the victims. I am now appreciative of the fact that my coming forward then changed things for me. I was careful about what I said, but it helped me to come out of the darkness and changed the dynamic internally. So it taught me a lesson that I could be effective without telling all the details.

I am mostly comfortable with being able to talk in a public language that sounds mostly "generic," but I do it while knowing inside that the reality is often quite a bit more complicated. Nowadays, I often talk with friends and family about "not being connected" or "feeling depressed." I know it sounds like the stuff of life that everyone has to deal with. Yes, on some level it is. And here, while I do often use a more "technical" language, I still am extremely careful about the words I use and what I share.

But, like everything in life, some people's experiences can be in the extremes. I find that there are safe and not safe—or appropriate and not appropriate—places to talk about these extreme experiences. I do not find it helpful to try to educate everyone in my life about what it is like to have multiple personalities or to self-harm because people are so affected by stereotypes. And here I am careful, for example, not to delve into details about traumatic memories. What I have learned is that stance is not invalidating. Rather it is a personal stance aimed at helping me feel safe. Perhaps it can be seen as my playing it safe. But, even though it is totally different kettle of fish, I would also not talk to a public audience about the intricate mathematical details of the Lennard-Jones potential in molecular modeling (which is what I do for work).

So, I have these boundaries in place and one may wonder if I am only creating an irreconcilable conflict by having such acceptance in therapy and being so careful about how I present myself outside of therapy. I could imagine that someone might think that if I am able to keep my "outside life" appear relatively normal, then am I only creating imaginary issues in therapy? If I just cut out all that uncomfortable stuff from therapy will my life just be so much easier? Is therapy creating my problems?

Those are all valid questions, and all are questions I have asked myself, over and over, in different ways for two decades. To be honest, this has often been a source of internal conflict and I have addressed some of these conflicts here and in my comments on others' blogs, even very recently. In September, I wrote The Uncertainty Principle. In that post, I wrote about the pitfalls associated with definitive answers to complicated issues. I wrote about how many psychiatric "authorities" can see the same person and draw very different conclusions. I wrote that we must challenge ourselves to ask tough questions, struggle with doubt, and find a way to live with friction.

In some ways, how I work in therapy and how I conduct myself publicly is a measure of this necessary friction. But, as I have said before, it is how we use friction that is important. We can let it become an insurmountable barrier and lead us down a path of a false set of beliefs that, on the surface, feels more comfortable. But I have never found denial to be a long-term solution.

Like I said in the last post, I believe when I talk in a specific language about parts of myself openly in therapy, in the hospital, and in my private journal, and am careful about what I say publicly, I find that is actually an approach helps me to heal.

One of the more difficult issues surrounding dissociative disorders is the so-called dissociative disorder language. Unfortunately, it is this language that is one of the reasons why dissociative disorders, including dissociative identity disorder (DID), continue to be controversial. Perhaps the most difficult aspect of the language is naming of dissociated parts of self.

I know there are many times when my therapist asks the dreaded question "Are you feeling grounded as Paul?" In the hospital, I am sometimes asked the much more ingratiating question "Who am I talking to?" Either can go down in one of two ways. One frequent response is to be taken aback and roll my eyes. I often feel like I am "Paul" but maybe a very different shade of myself, and so the questions feel incredibly awkward. But then there are clearly times when I (or rather a part of me) readily answers to a different name. I suppose there is a middle way and that is that I am taken aback, but then realize that I am only acting as a barrier to some other part of me.

I believe, and this is based on my personal experiences, that the complexity of dissociation and how it manifests drives this type of necessary communication. My level of dissociation varies enormously over time. On one side, I can often be relatively whole with access to many parts of me, experienced mostly as "shades of myself." But, on another, I can also often be very fragmented with little awareness of anything beyond what some narrow segment of me knows. As a result, there is no "perfect" (or probably even easy) way in therapy to interact with me, and while sometimes these questions feel uncomfortable, there needs to be space to ask them. If we are not direct, there is a huge potential to avoid addressing very real internal needs, which can then lead to problems such as safety issues or intolerable internal conflicts.

In therapy, the place where I make a deliberate and focused effort to heal, there really is no other language to describe the very real partitioning in my head. We use names for parts because they have names, and to not use names would make communication difficult if not impossible.

I have always struggled with names of parts. I realize that some believe the very notion of having names for parts causes more problems or even creates DID. I can understand that argument. For those of us with dissociative disorders, I think we need to come to our own personal understanding and response to such a message. For me, accepting that argument leads to denial and barriers. But, and this is a very big but, having names for parts should not ever be an excuse to take away our personal responsibility. I have seen this over and over again. We must own our actions, even if a part of us, with a name, did them. I believe it is crucial to keep that perspective.

Names for dissociated parts of myself is one aspect of the language that my "system" (if I can use that word) ended up using to make sense of that system. While I know there were names associated with parts way back when, they were not so clearly defined as they are now.

A number of the "hurt" parts were always thought of as shades of Paul or "young pieces of Paul." So there were many variants of the name Paul. And also there were "characteristics" as names, like "Dirty One", "Sexual One", "Evil One", etc. My experience of my dissociation as a kid and young adult was always in those contexts, with huge holes in my awareness.

Back in 1991 when I found myself in the mental health system and my level of dissociation became more apparent, there was a more clear defining of names as a way to talk about experiences so that my treaters and I could find common ground. It is so much harder to say "the part of you who is very spiritual and wants to go to church and holds a lot of physical pain" than to just say a simple name.

The names of parts are much more specific now, and while this is one of the sources of controversy concerning DID, this increased specificity has helped me in so many ways. I have long accepted that I have extremely compartmentalized parts of myself, and if I did not address them head on, I would be at an extreme disadvantage.

Being able to define parts more clearly allows me to know more specifically what parts represent, what their issues are and what their needs are. It has helped me put the pieces of my self and my life back together. It has helped me to be more whole and more functional in my life. It helps me to be more aware and safe. But most importantly, it has helped me to heal.

There has been a debate for at least two decades concerning the diagnostic validity of the dissociative disorders, in particular dissociative identity disorder (DID).  Anyone who struggles with DID has seen this, probably firsthand. On its face it is not hard to appreciate why there is such controversy. Some just dismiss the disorder outright because far out experiences like having such widely varying personality states (often with their own names even) seems implausible.  For others, they believe it is either therapist misleading or patient collusion to exaggerate symptoms much like an actor is required to perform for a scene, and there is some historical evidence of this.  Many talk about the validity of the experiences, sometimes referred to as the "Swiss cheese" of consciousness, but believe they should be subsumed under other diagnoses.   

I talked about this subject a year ago in Is Dissociative Identity Disorder Real? I want to come back to it today.

While I talk about dissociative identity disorder fairly regularly here, I do not generally like to treat it so separately from other forms of dissociation.  That is not to say that I do not think DID is not a valid diagnosis. I absolutely do. For one, I think much of what those of us with DID have to contend with is similar (though on a different scale) to what many others have to contend with.  I think many appreciate that dissociation-like experiences are widespread in the world, if we include things like avoiding difficult situations or being disconnected from our families or not being aware of what we are doing. Of course, most people's experiences do not rise to the level of being diagnosable dissociative disorders.  There are billions of people who seek more awareness and deeper connections in their lives, which at its core, is what healing from DID is all about. And, while dissociative identity disorder is usually singled out, those who are recovering from childhood sexual abuse and have been diagnosed DD-NOS, PTSD, Complex PTSD, Borderline, or nothing at all also have a challenge to find more wholeness in their lives and heal dissociative tendencies.  So, I always try to use language that applies broadly. This is the main reason why I often avoid much of the parlance of the disorder, even though I completely accept the validity of the disorder.

Because DID is an elaboration of what all people experience, this leads to a bit of a "Catch 22." It is a problem because this is the argument many detractors use.  But it is also an advantage. Personally, I want to struggle with something that, on a fundamental level, is normal to the human condition. That gives me hope for healing. If DID, and other dissociative disorders, are on a continuum, then I do see healing as finding a way to move down the ladder of that continuum. For me, that makes it all much more manageable. Yes, there are many times when I feel utterly not normal. When I am at my most fragmented. When I have bitter wars inside. When "I" do unsafe things that I would not possibly agree to in any rationale or grounded state.

If we focus on the messages that detractors use, there are usually two outcomes: becoming defensive and succumbing to denial. For me, I find that I start with the former and end up in the latter. But this is dangerous ground. Becoming defensive tends to push one towards a rigid stance that does not appreciate "both sides" or seek a middle ground. And denial can be hugely destabilizing. While some denial is part of the natural healing process, it is not part of the overall solution. I know that firsthand. For several years, I fled therapy, appeared well, disavowed parts and pretended it all did not exist. But I also know that during that time I was not paying attention to what was happening in secret.  There was an upside: I ended up quite functional in certain very public areas of my life. But, that came at a severe cost, as I was quite dysfunctional in other areas. For me, that "position" did not stick. It was not in line with what I needed to do for healing. For some people, and I am one of them, multiplicity is very real and part of the fabric of who we are.

I now know I need to have acceptance for the "multiple" way my mind works, though I struggle with this a great deal. This acceptance has helped me change; to be more whole and heal. The goal of good therapy for dissociative disorders is to become more whole. Period. To move from what is more like "Swiss cheese" to what is more like "American cheese." The route is through increase in awareness, which is proportionally difficult to how elaborate the dissociative walls are.

Another issue that is often brought up in any discussion concerning perspectives on multiplicity is Sybil. Sybil defined late 20th century multiplicity. But dissociation is experienced on a continuum. It was a mistake for many therapists in the 80s and 90s to think that everyone was in the Sybil mold. There is vast understanding of a continuum of experience now. Good treatment now does not involve abreaction, regression and purging of memories. That was a lesson learned a long time ago. But rather it is to promote a more whole way of living that holds one's self accountable for actions and teaches grounding and other techniques to quell what are very real, and sometimes extreme, internal conflicts and disparate views of self.  And as far as memories go, good treatment does not make them a focus but does not shy away from them when they become an issue. Good treatment works towards containment so that survivors can deal with issues of the past while also learning to navigate through life in the present.

While therapists have a responsibility in the treatment of dissociative disorders, survivors clearly do also. I firmly believe this. Anyone who uses their multiplicity as a means of scapegoating behavior, or puts their whole life in the identity of a multiple, or only identifies as a victim, is putting up an enormous barrier to their own healing and doing themselves a disservice. Survivors (and therapists) need to know there are no guidelines for being multiple. It is recognized that multiple systems are very different for different people.  People with DID (or any dissociative disorder) should not be pushed, by themselves or others, into a belief system that says you have to have X parts, or have this level of trauma, or that you have to have these types of parts, and they have to behave in this sort of way, etc. In other words, we must be driven by our internal truth and not by external pressures.

I believe that if we are guided by truth, we will achieve more clarity. I have found that I have fewer internal conflicts, I am more whole, I am more functional in the world, I am able to feel more, etc., when I accept what I know to be a reality of how things are inside. That is another way of saying I accept my truth.  When I do not accept what is real for me then nothings fits together.  The bottom line is that everyone has to come to terms with what their reality and their truth is. That acceptance should be respected by others. And that acceptance is the basis for change, growth, and healing.  

I will expound upon the subject of truth that I brought up at the end of this post in a subsequent post. Truth is the theme for both the Blog Carnival Against Child Abuse and the Expressive Arts Carnival this month, both hosted here. I welcome writers and artists to submit to both as I think truth is a crucial topic that can benefit from several different perspectives.