Dissociation preventing any progress in therapy

[Deleted member 39476]

Has your therapist discussed with you the concept of "learned helplessness?

Yes and I do have it but I don't believe it really applies here. I established that I do have a certain fear of healing to some extent because in order to recover you become whole, and for me to become whole with some extremely toxic parts would either mean corrupting my entire mind, or having those parts die off, which are both very scary propositions. Also it is definitely true that I have an excessive sense of helplessness and desperation right now, part because of my extreme level of stress that makes things look extreme, part because I've felt like this on a chronic basis for a very long time and nothing I've tried helps.

I'm not rejecting these ideas because of that though, I'm not just assuming they won't work, I have either tried them and they don't work, they are so similar to something I have tried that I already know they won't work, or they are things I cannot do to my extreme level of stress, dissociation, and executive dysfunction, or they are things I just don't like on a fundamental level.

So, you cannot focus your attention on anything, in any way, to any extent, for any length of time?

It's kind of an exaggeration and it's kind of not, I am in very strange circumstances. The easiest way to explain it is I can only pay attention to things unless I have a reason to be obsessed with them due to fear or something else. For example, if I am playing a game, my excessive level of hyper vigilance transfers into the game and I can pay extreme attention to everything happening in the game. I can't concentrate in a normal way on anything at all though, ever. At no point in the last year have I just had a reasonably clear mind, and been able to just concentrate on what I'm doing any nothing else. My mind races at an absurd pace 24/7, the only way I ever get anything done is if my extreme level of stress and fear transfers from focusing on something in my life or in my mind, to something happening around me. In order to consciously attempt to control this, the only thing I have found any success with is strategically setting up myself to be distracted by the thing I want to do from something else I am doing.

Is there anything in the suggestions here that you haven't already tried, which you are open to having a go at?[/QUOTE]

So far I don't think so, but I could be forgetting something. I have tried a ton of different things already so the majority of things that have been posted I have already tried. I won't consider anti-psychotic drugs unless I feel like I'm actually going psychotic, which so far I am not, and in that case I would still probably rather die than take those kinds of drugs, just a personal thing, although apparently they have really bad effects on people with depersonalization problems. A couple people recommended hospitalization or some sort of in-patient care, so far not considering either of those options, I don't see what benefit either of them would have for me, I'm functional enough to basically live just not enough to live happily at all.

The other main option people keep bringing up is the top-down methods. I hate those on a philosophical level, I strongly hold the belief that these problems are foundational or bottom up, and must be treated as such. I do agree that challenging thoughts and consciously trying to maintain a positive attitude is helpful when you are moderately stressed out, but I believe it's completely useless as a long term treatment, also totally useless in short term treatment for people under very severe stress, and especially bad for people like me who are so deeply divided internally that we lose control over ourselves in a big way. In my case what happens generally is I try something out, such as meditating or deep breathing, it causes me more pain instead of helping at all, and then some part of me becomes very afraid of doing it, so even if I were to try to consciously take control of the situation and tell myself "at X time every day I will at least try to do this, even if I don't have success initially" some part of me would take over when the time comes and say "hell no, all it does is make me hurt more."

A couple other notes I would like to touch, people asked what I'm really here for if I'm not considering a lot of advice people are giving me. I'm here to see if there's some sort of novel technique or therapy I can try to use to reduce my absurd stress level that I haven't considered, or if anyone has successfully gone through and resolved what I am going through and what got them through. Also I am not just doing EMDR. The main line therapy my T does is EMDR, and I guess technically a lot of what I am doing could be considered the earlier steps in EMDR protocol, but we rarely actually do any EMDR due to my extreme level of disturbance, and are instead trying bits and pieces of many different therapies and approaches to try and find stability before doing any actual reprocessing. I am definitely open to other things and am already doing different things, I just don't like the top down therapies like CBT.

 

[Justmehere]

I think grappling with the fear of those toxic parts taking over or dying off as part of the process of recovery, is where your primary work should be focused.

Many people have been where you are and gotten better, and they are telling you about their paths to get better. Try re-reading the thread with a focus of looking out for those incredible stories of recovery they have been sharing with you. Low-dose naltrexone is not an anti-psychotic but an opiod antagonist that directly treats dissociation. People have also described ways to use skills that do not mean mediation or just having a positive attitude. Try re-reading the thread with an eye out for any new things that have been suggested that might be helpful to you.

But back to the fear of those parts and the learned helplessness. I've found that for myself and many others, those "toxic" parts are parts of self that developed during trauma to try to keep me safe, once integrated into the rest of me, they are actually quite useful to have. They don't take over and they don't die off.

Everything else is probably secondary to working through your fear of those parts taking over or dying off. No matter what you try, I think you'll find some reason why this or that theraputic technique doesn't work, no matter how "novel" the technique, until you are ready to risk the possibility of having to deal with those parts of self.

As much as you are trying to avoid dealing with those parts of self now, they are probably already keeping you stuck and miserable anyhow.

Studies have shown that while the theraputic technique is important, it isn't the most critical factor in the success of therapy. The single biggest predictive factor in therapy being successful is the relationship with the therapist. From what you describe, you have a great relationship with your therapist, who seems very knowledgeable, and you are even sticking with the therapist even though you describe that almost every technique they use is backfiring.

So lean into the relationship with the therapist.

I know, you already have reasons why that's not enough, and the symptoms are too overwhelming. I hear you on that. The choice is truly yours to try this in a new way, or stay where you are now.

Internal family system therapy isn't novel to the world of psychotherapy but might be new to you, and has little to do with focusing on what one feels in their body and isn't a "top down" approach. It will get right it the heart of the work. If they know about IFS, ego state work, and how to develop what is called an internal dialogue, it might be quite helpful to you in working through the fear you have of those parts taking over or dying off.

 

[Deleted member 39476]

Internal family system therapy isn't novel to the world of psychotherapy but might be new to you, and has little to do with focusing on what one feels in their body and isn't a "top down" approach. It will get right it the heart of the work. If they know about IFS, ego state work, and how to develop what is called an internal dialogue, it might be quite helpful to you in working through the fear you have of those parts taking over or dying off.

You entire post basically describes my situation exactly, and we are using inner family systems to grind out that deep fear of parts, develop and internal dialog. I really feel like that is truly the rootiest root of the issue, it probably cannot really get any deeper than that, I figured that out a few months ago and have been trying to get through it for a long time now. The thing is, if you are in a normal state, try to develop an internal dialogue in therapy, mistep and trigger some serious stress, understandably it would be extremely difficult to keep the dialogue going as one part of you if not both is now overwhelmed and terrified. Normally what you would do is work with that, be very cautious and respectful, try to calm down, and work with again later after you have calmed down. My situation is that I triggered myself so hard at some point that I am triggered like that 99% of the time. Once in a blue moon that part of me calms down enough to be able to talk, but those times are few and very far between, maybe once every couple months for a few minutes at a time. It's a really brutal catch 22, that is both the cause of my stress and the deepest root of my issues and without a doubt the wisest primary focus of therapy for me, but also something that cannot be worked through under such a severe degree of stress.

In my case the part of me that is holding onto most of my trauma is the toxic part, and it is an imitator, which means that it came about to protect me from an abusive family by pretending to be like them in my head, keeping me in line as to avoid getting abused in real life by my actual family. Given that nature, it is fundamentally extremely challenging to work with. Imitators disguise themselves as monsters, which not only terrifies all your other parts, but can trick you into thinking that it isn't even a part and is just what other people are actually thinking about you, so in order to work with it at all you need to get it out of its disguise somewhat, but its extremely difficult to get a part that is holding almost all of the trauma to let the disguise down because that part itself is extremely terrified and extremely sensitive. Under stress it reactively morphs and shifts to avoid being revealed. It's an unbelievably stubborn thing to work with.

 

[Justmehere]

The thing is, if you are in a normal state, try to develop an internal dialogue in therapy, mistep and trigger some serious stress, understandably it would be extremely difficult to keep the dialogue going as one part of you if not both is now overwhelmed and terrified. Normally what you would do is work with that, be very cautious and respectful, try to calm down, and work with again later after you have calmed down.

I see. So if I understand right, you are trying to have the "normal" part, speak to the toxic part/part that holds all the trauma, and getting too overwhelmed to continue the work? That makes sense as to why that's not working. You are jumping right into the deep end without a strong hold on a life raft.

What about not trying to talk to that toxic part but to the part that is so scared and overwhelmed? That part is here right now. No needing to dig up trauma or stuff that triggers more.

Another suggestion - instead of just talking, which I find to be much more intense and harder to pace, and more triggering, try writing. You write very well. It may be a real tool for you in this work. I had to first journal internal dialogue work with the part of me that didn't want to do internal dialouge work and thought it was stupid. Then I did it with the part of me that was really scared and resistant to the work, and overwhelmed in daily life. After a year of doing that, inside and outside of therapy, it was only then that I even tried to remotely touch the work with the parts that held the trauma.

And when I mean I journaled, it writing letters to myself at the pace of where I wrote two words and walked away.... then wrote another two words a few days later. Then it increased to one sentence at a time...

It won't be symptom free. You will feel terrible. That's part of the process. You are able to write here even while being in what you describe an almost constant state of distress and being triggered. So keep writing.

When I first started off, I did not do it even with my own parts, but as if I was talking to someone else. I first started with writing what is called a rainy day letter, but I wrote it to someone else. A pretend person. Jane doe. It started off "Jane doe, I hear you. This is horrible and overwhelming..."

From there, I then wrote letters to myself, and not about the past, and nor about the trauma, but about today and the suffering I was in today.

Eventually I was able to write to the part that was scared and overwhelmed - the inner child, like here: A Letter To My Inner Kid From My Adult Self

It's only after that did I really even start to do the parts that really held on to the hardest stuff.

The part of you that keeps hiding from this work or otherwise scaring you is doing that because the rest of you isn't connected and resources enough to help that part walk through this. So work on those other parts.

Does this make any sense? IFS work is really hard to describe and can look different for different people.

 

[JEKBreatheandBelieve]

A couple people recommended hospitalization or some sort of in-patient care, so far not considering either of those options, I don't see what benefit either of them would have for me, I'm functional enough to basically live just not enough to live happily at all.

You can be functional enough to live, but not enough to live happily or meaningfully. I think that's the benefit of hospitalization (in a focused setting) is that it helps with securing true functional living and though it may not provide happiness, it at least points you in the path towards it. Though I have seen people enter into hospitalization and not be open enough there for it to be helpful, but it's an idea I still like

when you feel like you're going to die, challenging negative thought patterns just doesn't accomplish anything. It's mainly useful in the context of trying to maintain a positive state once you enter one.

I have to respectfully disagree with that. I find when I feel like I am going to die is exactly when I need to challenge my thoughts. If I were already in a positive state, I wouldn't need to challenge the negative thought patterns. CBT used to throw me into huge panic attacks when I tried mainly because I had such black and white thinking and fear of being wrong that I actually thought that if I challenged my thoughts then I was saying my current thoughts were wrong and I wasn't allowed to be wrong so I couldn't do CBT. That might not make much sense to you, but my point is, it wasn't easy for me to accept and try CBT. I still don't prefer CBT, but the challenging negative thoughts and cognitive distortions has helped me a lot once I worked on it and it did take a lot of work. Now I have challenges to negative thoughts/distortions posted around me on index cards so I can review them frequently.

 

[Deleted member 39476]

The part of you that keeps hiding from this work or otherwise scaring you is doing that because the rest of you isn't connected and resources enough to help that part walk through this. So work on those other parts.

If I remember correctly that was basically how we started doing it initially. The process starts off as "imagine a meeting room in your mind's eye, where all the different parts of you can meet in safety, invite all the parts of you to come into the room, what happens, who shows, up?" At first the room filled up with 5 or 6 different parts, ages being roughly around 2, 5, 8, 11, 18, and this vague mysterious ageless and formless part just kind of in the background. As we started talking to them, figuring out why they were there, what is wrong, etc, 3 of them disappeared entirely, 1 of them sat on one side of a table, 1 on the other side, and a little child sitting next to the one on the other side. Over time the mysterious one kept shifting and morphing until the room eventually morphed into a table with one part sitting at it, meanwhile there was an extremely dark, extremely monstrous force surrounding and permeating the room. The quality of safety and dialogue declined to the point where my other parts aren't there at all, they disappeared outright, the one part I can see, and that is friendly with "me" (perspective gets really confusing when writing about this) is so terrified of the monster that he does not talk at all, and the monster itself which I can talk to any time I want to but which is obviously hostile most of the time. There is such an insane degree of fear and tension between that part and every other part that it's nearly impossible to foster any communication between them at all, but we cannot do anything about the fear because the monster part is carrying so much of the pain that even indirectly referring to it, or to the trauma, or to its fear, or to the other parts fear, causes my stress level to go from a 9 to a 10 at which point I go from mostly dissociated to completely dissociated and my brain mostly just shuts off.

To really make any progress the steps that need to happen are something to the effect of:

1. Reduce stress and fear of the monster part so I can interact with it without triggering myself
2. Foster relationship and internal dialogue between parts
3. Attempt to resolve the tensions to the point where I can act as a whole person
4. Achieve some level of emotional stability
5. Attempt to reprocess trauma.

I've been stuck at step 1 for a very long time though and I'm having a really hard time figuring out what to do about it.

 

[Justmehere]

I would add many possible steps prior to this:

Reduce stress and fear of the monster part so I can interact with it without triggering myself

Step one is not to reduce fear to interact with the scariest part. Or to have any part of you interact directly with the monster part right now. That's not what I'm describing. You are trying to jump into the deep end, perhaps counterphobically, by making this step one.

Step one is to slow this way down. I would not suggest picturing a table with all the parts there. I'd interact with one part and not about the monster but about the here and now. I understand that the monster is taking over each part... you've invited them all to the table with no boundaries in between. So reestablish, set, and keep those boundaries. You are an adult and those inner child parts need an adult right now to step in like a momma bear and say nope, no monsters allowed in he room right now. That's part of the work.

What would you say to a small child scared of a monster? Do you know? What would you do to help protect them? If it's too hard to think to doing for yourself with those parts, approach this as if you were taking to someone else that is not you, a child, that has a different monster of their own. What would you as an adult say or do for another child?

Someone needs to stand up to the monster and set some limits. Not in a way that shames or blames the part, but simply says not here not now.

Some therapists will use the idea of putting the monster part in an imaginary jail or box, stuck in the therapists office. You can use other types of imagery with this too. Will of work 100 percent the first time? Probably not. But that's not the point. It's a muscle. It needs practice to get stronger and even more so, those scared younger parts need someone to finally stand up for them. Kids get less scared when they know a safe adult is around to protect them.

Does this make any sense?

There are other ways to approach this using other techniques, but if IFS is the form of therapy you are willing to use, then you need to work on internal boundaries as a beginning step in the long path to integration.

 

[Deleted member 39476]

You are an adult and those inner child parts need an adult right now to step in like a momma bear and say nope, no monsters allowed in he room right now. That's part of the work.

This is what we are working on and where we are stuck, hence why stress reduction is still priority number one. I absolutely need to be an adult and set boundaries, but I am not an adult and I am not in control, that is the problem. Numerous times we have done experiments to confirm the age of the "monster" part to see what's actually going on inside. Every time I let that part totally take me over I have really strange experiences. Due to the very complex nature of it, I simultaneously feel like a helpless infant who is in some terrifying situation for which there is no escape, while also feeling like a monstrous adult who is afraid of feeling like a child because its hard to maintain a facade of being a monster when you appear and act like an infant. It is mainly that part which has the most fear, because that part is what holds most of the trauma. In order for that part to feel safe enough to start the process of recovery, it needs to be protected, presumably by adult me. I cannot protect him though, partly because he is usually in control of me and an infant cannot protect itself in danger, partly because I usually cannot even view him as a child that needs my help, all that part usually does is imitate people who have hurt me and remind of terrible things that have happened to me constantly. In order to establish any sense of boundary, safety, or inner communication at all, the stress level needs to come down first, under severe stress that part totally takes me over and there's nothing I can do about it on my own.

I have an inner child who is very scared who needs me to take care of and protect him more than anything else in the world, but the parts job is to protect me by completely disguising himself and acting like an abusive adult towards me almost all the time every day. A hell of a catch 22.

 

[joeylittle]

I won't consider anti-psychotic drugs unless I feel like I'm actually going psychotic,

I just wanted to poke my head in and say, that's not really all they are used for.

It's fine if you don't want to look to meds. I avoided medication very aggressively for a very long time - I had strong reasons. I get it. But don't fall into the trap of mis-comprehending what the drugs do.

Breathing: I recommend you try it again. A simple one is slow 4 count in, hold for four, slow four out (through pursed lips, like blowing out a candle), hold for four. You need to do it for at least four minutes, and the first minute/two can feel like hell.

Or, try an app. I like Breathe To Relax. (B2R). It has a nice visual. Set the exhale at twice as long as the inhale, 6 in and 12 out is a good starter. Again, you have to commit to doing it for around four minutes. Most people who experience that breathing doesn't work for them, and that it makes them feel worse, are stopping much too early.

 

[Sideways]

Mindfulness and meditation are 2 different things.

Mindfulness can be as simple as: the last time you saw a photo of a cat doing a funny thing on the net, and for just a few moments you just thought about, "Hehe, that's cute/funny/amazing/scary"... Those few moments? Were a state of mindfulness.

The last time you bit into something and it burnt your tongue and for a moment you were completely focused on "Ouch! My tongue!" That was mindfulness.

Your posts make it seem a lot like you're thinking that some of these processes are more complex than they really are. Take a breath, keep it simple. Remember that people here get it, and are with you for your journey:)

 

[Deleted member 39476]

Mindfulness can be as simple as: the last time you saw a photo of a cat doing a funny thing on the net, and for just a few moments you just thought about, "Hehe, that's cute/funny/amazing/scary"... Those few moments? Were a state of mindfulness.

I haven't experienced that in over a year.

 

[Sideways]

And yet you've described using distraction in this thread, and also becoming completely engrossed in video games...?

Over-generalisation is a cognitive distortion, and it seems to be making it really difficult for you to be able to identify some pretty major successes that you've had with your recovery so far, and I can imagine that would make the future seem impossibly hopeless.

For example, you not only have identified your parts, but you can also write (really well!) about them, their ages, their roles, and the complicated nature and interaction with the monster part.

You seem to get very caught up in the hopelessness of your extreme and complex situation. But just from having observed this thread, it's clear that actually you've achieved a whole heap in your recovery to date, and what you're experiencing, for all that it's incredibly distressing and overwhelming, is actually very common among sufferers on this forum.

Is there plenty more progress to be made? Sure. Are things ok as they currently are? Absolutely not. But try not to write off the progress that you have made. Accept small wins and achievements when they occur. It's a big part of what keeps us going.