Requirements for the Proper Multiple

Tonight, I was talking on the phone to the organizer of the DID support group I was a member of for two years until I got kicked out for presumably not having DID last May. She guessed my diagnosis correctly, but went on to assume I'd imagined my DID. Well, I'm going to be completely honest here: I have indeed internalized some symptoms that I didn't have before my diagnosis, like the amnesia, but I had known for almost ten years that I had parts when I was diagnosed. Did I imagine the splits when I was fifteen-years-old because I wanted to be crazy, while I'd never heard of DID back then? Well, I don't think so. Of course, whether these emotional states are truly dissociative or not, depends on your perspective. The organizer got to saying incorrectly that BPD and DID have nothing in common. In reality, many people believe DID is BPD with more flair.

The organizer got talking of me quoting books on the furums. Well, that doesn't say anything, does it? Just because I listed the criteria of BPD yesterday, doesn't mean I don't have BPD, right? Apparently, if you want to be authetnic, you're going to have to have made up your own symptom list without any influence from literature. I wonder how this person, who studied psychology at university, did this. Apparently, people who've studied mental disorders in college cannot be diagnosed with a mental disorder themselves.

To air off a bit of steam in a healthy way, I'm going to repost and expand on the list of requirements for the proper DID'er that I compiled after being kicked out of the support group.

1. You can't use jargon like "co-conscious", "inner self helper", etc. if you've not had your diagnoisis forever. This is not supposed to be familiar language to a person just diagnosed.
2. Even if you know you've got parts because you've established a fair amount of communication, you can't walk into your therapist's office saying you experience parts in yourself. In fact, you cannot have obvious dissociative symptoms. According to what I've been told, saying things happen to you but not quite to you, is not appropriate either (which is what I really came into therapy with).
3. You must've gotten into therapy with seemingly irrelevant symptoms like depression, self-harm, etc. Then it's the therapist's duty to figure out you're multiple, but they can't just straight out ask if you experience parts in yourself. On occasion, they can, but you must be completely clueless to the fact that it's not normal.
4. You must have some doubts about your diagnosis, and you must fear that it's all real. If you fear you're fake, you're obviously already a faker.
5. You must not switch too openly or demand switches be acknowledged, cause DID is something that's supposed to be hidden. Keeping the dissociation hidden must be an end in itself. Note that you won't get a diagnosis of DID if the diagnostician hasn't seen you switch.
6. You must want to integrate.
7. You cannot have littles who write properly. You also cannot have littles who write improperly but on the right subforum, cause how are they supposed to know where to write? However, you can't have alterrs write on the main forum either. Why else would there be specific forums for alters?
8. You must recognize just enough of what other DID'ers, who obviously all are not fake, say they experience, but not too much. You must be able to articulate your experiences in your own words, and others determine whether you use your own words.
9. You must have time loss, but how you're supposed to know you have time loss, is unclear. You can't just say you lose time when others come out, cause how do you know? You cannot say you don't remember something when asked, because then obviously you could pretend you forgot. I don't know how a therapist is supposed to realize you lose time if they cannot ask, especially given that implicit memory is often intact in DID, so DID'ers act like they do remember what other identities did.
10. In meetings, you must present as the host (with the birth name) at all times. You must be oriented to the present if you want to participate in meetings. On the other hand, you cannot actually be the person with the birth name, cause that person must've gone to sleep, been gone at an early age or be totally unaware of any others. How are you supposed to come to a DID meeting if you are clueless about other personalities?
11. You must have survived horrific abuse, but in this partiuclar group, you cannot talk about it in meetings. You need to drop the occasional SRA reference to make clear that you are an authetnic survivor.
12. You must validate others' every experience, but you cannot say you can relate.

In short, you're required to have just enough in common with other people in the group to be able to benefit from shared experience, but you cannot recognize too much or it'd be seen as imitating.

Comments on Schema-Focused Therapy

When I was told that I have BPD on Monday, my therapist got talking about maladaptive schemas. She apparently assumed I knew what they are. I had some idea, but did a quck search to find out anyway. They are beliefs about yourself that are maladaptive and that have usually been formed in childhood (although they can be formed later on too) and repeat themselves over and over, thereby influencing your coping mechanisms. The creators of schema therapy list 18 such schemas. The ones that most apply to me are:

• Abandonment/instability: the belief that you will be abandoned by important support people or that the relationship is unreliable or unstable.
• Mistrust/abuse: the belief that other people will aubse, hurt, humiliate, lie to or otherwise take advantage of you.
• Defectiveness/shame: the belief that you are defective, bad, unwanted, inferior or invalid.
• Dependence/independence: perceived inability to handle your everyday responsibilities without lots of help.

That last one is a bit tricky. While I know I'm depenednet, I don't know whether this is entirely due to my beliefs. I mean, overload comes into the equation too. I got a bit pissed when my therapist wrote in my treatment plan that I have a fear of failure and need to realistically learn to take on challenges. As if I'm not trying!

Then my therapist got talking about schema modes. I had some idea of what they were because my former therapist had talked about them when I first disclosed I had parts. Schema modes are the emotional states and coping responses we adopt when faced with life's challenges. I found it interesting that the Schame Therapy Institute says that they can also be seen as dissociative parts. The Institute lists several different schema modes, including the vulnerable child, the punitive parent, the detached protector and of course the healthy adult. I recognized almost all of them, but in fact have more than one of each. Yeah, I'm not going to abandon the DID concept just because it isn't my diagnosis anymore.

Now schema-focused therapy is used to identify and challenge these maladaptive schemas and to reinforce the healthy adult mode. The assessment phase is followed by the change phase, in which clients learn to challenge their schemas and gradually focus shifts from experiential change to behavioral change and preparing for ending therapy. My therapist put in my treatment plan that the current focus would be on learning about origins and continuation of schemas and that I would recognize my coping mechanisms and hopefully be able to shift them in an early stage.

BPD Criteria and Me

Yesterday, I came across someone going through the BPD criteria and describing how he met them. I thought I would do the same, so here goes. My diagnosis was based on DSM-IV-TR criiteria because the Netherlands has not yet implemented DSM5. You need to meet at least five criteria out of nine. I meet at least six and most likely two more.

1. Frantic efforts to avoid real or imagined abandonment. Well, I have a huge fear of abandonment, but my attempts at coping with it tend to lead to actually being abandoned. I often can predict when someone is going to abandon me, but am not sure whether this is a self-fulfilling prophecy, good empathy, or magical thinking.
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. This is the one criterion I mostly don't recognize. Oh well, I do on occasion push my husband away by saying I don't love him anymore. In this sense, I am the stereotypical "I hate you, don't leave me" type. My husband says his presumption about borderlines is that people fight tooth and nail then five minutes later are cuddling.. I don't do that.
3. Identity disturbance: markedly and persistently unstable self-image or sense of self. This is definitely me. As I pointed out in a previous post, I have no sense of self at all beyond the labels I carry, and in fact am just learning to use my own labels rather than those stuck on me. I tend to have my identity depend on how others see me.
4. Impulsivity in at least two areas that are potentially self-damaging (eg. spending, sex, substance abuse, reckless driving, binge eating). Binge eating an running off into dangerous situations for me (ie. going for walks without watching for traffic). This is not suicidal behavior. Spending when in a hyperactive mood.
5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. Well, I self-harm and often make suicidal threats. when talking on the phone with my sister about my new BPD diagnosis, she said that mild self-injury like I do does not really count and that I make suicidal threats for attention. Well, I disagree with the "for attention" bit but really it doesn't matter.
6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). This is so true for me. I have rapidly shifting moods from irritable to anxious to hyper etc. My sister got talking of manic depression, but then moods have to last for a couple of days to weeks. Mine don't. I return to "normal" (ie. slightly depressed and irritable) or another mood episode within a day or so.
7. Chronic feelings of emptiness. I'm not really sure about this one as I have good reason to feel empty, ie. no job or extensive day activities. Then again, the feeling of emptiness can come for no reason and go with another perseveration or impulsive action.
8. Inappropriate, intense anger or difficulty controlling anger (eg. frequent displays of temper, constant anger, recurrent physical fights). I don't physically fight but I do have recurrent temper outbursts. For me, I'm not too sure whether they're meltdowns or outbursts, but I do have them in situations other than when overloaded too.
9. Transient, stress-related paranoid ideation or severe dissociative symptoms. Well, duh. I have both actually. I get terribly paranoid when under stress and obviously have dissociative symptoms, ie. feelings of not being myself, chronic depersonalization and derealization, occasional amnesia.

I have been trying to find DSM5 criteria, but can't. I know a new model for diagnosising personality disorders has been proposed, which bases the diagnosis on a combination of impairments in personality functioning and personality traits, but this model is used for research purposes only.

Autism, Special Interests, and Elevated Moods

Many years ago, I read an article on Suite101 or About.com or the like that discussed similarities between Asperger's Syndrome and bipolar disorder. The parent who wrote the article described her son's mood swings from elated to depressed. However, she realized that these mood swings were related to whether the son could engage in some special interest.

I find the same thing happen to me, but in my case, it also ties in with the dissociative or emotion dysregulation symptoms. I find that when I'm in a particular personality state, I engage in a certain special interest a lot more than when I'm in another state. For example, Clarissa is my blogger part, who is behind most of the posts on this blog. Annemiek is my crafter. And I at this point can't think of anyone else.

Getting back to mood swings, I must say that I get very elated when I engage in a particular interest for a certain period of time. I uttered the phrase that I would've been manic if I experienced this (mania) at all. In a way, this is extremely inappropriate and comparable to when a currently mentally healthy person talks about "going all OCD". I in no way want to say I suffer from bipolar (hypo)mania, but these mood swings do get problematic at times.

For example, last night I didn't sleep at all. I spent around $80 on useless online services without even bothering to read the not-so-fine print that clearly said these services would not be working for me. I actually took a PRN Phenergan at 2:00 AM, before I went ont he shopping spree, but swung right through it. Phenergan, for those not familiar with it, is a strong tranquilizer or low-potency neuroleptic. I'm now relatively calm again, so again I in no way mean to compare myself to people who have these experiences for weeks on end, but I do see actually how this could become a problem.

So, should autism parents limit their children's special interests in order to prvent this from happening. I don't think this is universally the case, but parents must teach their children about time and money management. I, having been pretty stingy as a child and teen, never really had to learn about this. I always had enough money on my hands anyway. I actually must say I have no clue about budgeting, and really don't know whether I need to learn it yet. I guess so.

From WordPress to Blogger to WordPress and Back

I have had a dozen blogs in only the past six months. Most were here on Blogger, but I had quite a successful WordPress blog a couple of years back, and no-one wants to come to my Blogger blog. Well, that's fine with me now, cause I want to be able to share my own stuff. It's fine if people come, but I don't want it associated with my full name, and that's what I did on WP. So here's my personal bloggy thing again.

I reside in a mental institution in the Netherlands. Have been institutionalized since 2007 when I was 21-years-old. Two months ago, I moved to a different institution to be closer to my husband, who lives in an apartment we rent. I was originally meant to go live with him soon, but we decided that's not good for either of us. I now need to find suitable housing in a supported living acccommodation or something.

You may see different names signed in my posts. This is because we're multiple. We have a diagnosis of dissociative identity disorder, although a lot of people doubt this diagnosis. Some laypeople say my alters are not real. I know they are. We have zero tolerance for identity policing. However, we will focus on our symptosm and not the diagnosis.