Structural Dissociation?

[Eleanor]

Suppose some subset of ADD (not necessarily with the H) is actually dissociation. The distractibility part is caused by switching, so it is not that one bit cannot hold focus in itself, it is that it goes off line, and another bit, who is not interested in that thing, comes on. When the original bit comes back on line it is STILL focused on that same thing, it never stopped. That is why lists work for some and not for others. If three quarters of you fundamentally doesn't care about the list, and a third of that doesn't even remember that there IS a list (because it doesn't have access to those memories.) That is different from what I take to be the usual understanding that there is a single motivational state and a person can't maintain focus within that state, although they have access to the relevant information and continue to want to be focused. Distractible is not a bad descriptor from the outside, but doesn't half do justice to the experience, and may just obscure the underlying problem.

Hyperfocus is then a really interesting thing! It seems like two things could cause it - being "stuck" in a single motivational state (and having other inputs vastly reduced because they are "offline" so they just don't register), OR being capable of really VALUING something highly enough that you can stick to it until some end has been achieved, despite being aware of other demands on one's attention.

@Kaia, my current understanding is that everyone starts out with parts. It is a task of development to integrate those parts into a functioning whole consciousness. The better integrated a person is, the more adaptable and ... equanimous (to use a yoga word) they are. So, like everything in biology, it is a spectrum. The problem is that when a person is really quite un-integrated (to the point that some bits are actually phobic of the others) it is a) maladaptive and b) painful in itself. Everybody puts on different social masks, sure, just like Muse just said, but some people keep continuity between them, and others can't. When trauma causes a split, and the activation system(s) (always a negative valences one) gets stuck in full ON position with all the traumatic inputs still lighting up in the brain (flashbacks), it can be very very very painful indeed. And a lot of us DON"T function very well. Because we, at the moment, CAN'T. That's what makes it a "disorder." If it didn't screw up your life in comprehensive and predictable ways it wouldn't, I suppose be a disorder.

Being comprehensible to strangers is a pretty low bar. Totally psychotic people are comprehensible. Wrong. But comprehensible. That doesn't mean they don't have a problem.

I'm not sure what exactly you mean by "self" (lots of people mean lots of different things) but part of the difficulty of talking about this stuff is that the term is so ambiguous, and we here, well, I at least, want to use it in some more specific and nuanced way.

Here is maybe a helpful analogy. When we are born, we do not have stereoscopic vision. The images we get from our two retinas are not fused into one 3-D image. That fusion is an achievement of neurological development. Some extremely unfortunate people are infants in situations that do not provide them with the experiences necessary to make those connections. After the window has passed... they are stuck with the two images. (As far as I know, perhaps some clever person has figured out how to correct this.) Such people can get around ok, but cannot do things that require high visual acuity and precise estimates of depth. The vision thing is a problem, tho not a horrible one for everyday function. The emotional things... they can be quite a different story.

 

[Ronin]

@Eleanor, noted and I'm glad for the response. However, my point was different - what I've seen with therapy of dissociation was a lot of focus on who or what is the person's core/self, restoration of it, and I don't think it's really applicable often; healing from the damage isn't the same as undoing the damage and physical changes by the damage.

(Basically a 'don't poke the wounds to heal differently if they have already, prevent new ones' idea. I think it may be rather confusing people if they have to be looking back at things they literally fell apart from. Mostly too long didn't read version, I'm worried about retraumatization in the name of connecting the dots.)

 

[greenleaf]

@Kaia -- there are a couple of different issues here, from my perspective at the moment.

One is that yes, retraumatization itself is bad if that's actually what is going on -- which could be the case if no effective therapy is being used for the person, *and* additional pain/symptoms/etc. are being caused. Some "Exposure" techniques, for instance, if used for people with pretty separate parts, might be in that category. I read some studies showing that many such folks never improved from it and just had a lot more issues.

A separate issue is that if the person has a structural problem but is sorta stable at the moment, is there an ethical issue for a therapist who realizes the problem to try to treat them with *effective* therapies? If there were a treatment for people with eyes that could not fuse an image, but the person managed to walk to work everyday, didn't even realize they have a problem, but they were at risk of in the future falling and breaking bones or getting killed by a car because they had no depth perception, wouldn't there be an ethical requirement for therapists to try to treat them? Not to mention the possible improvement in quality of life from having better vision (or, in this case, ability to more fully connect with others and sometimes even just experience positive emotions deeply at all). This could be very tricky, I understand! Lots of possible problems and therapists seem to focus a lot on stabilization and such because we can have risky reactions and stages while working on our issues. :confused:

I love @Eleanor 's vision analogy. I have some muscle areas that had been numb; I have been getting some feeling back in some of those shoulder areas but they don't feel exactly continuous with other body areas in a weird way. Hard to describe but the images not integrating seems really similar (having been at eye doctors many times for regular glasses; those doctors do things to make the images split, and see when your brain/eyes can force them together). I'm hoping my brain will improve with these muscle/feeling issues. Maybe if I keep pouring chocolate into my head? Don't new neurons require chocolate?

 

[MomOfTwo]

I have been lurking a bit on this thread... reading insights from everyone :) My therapist does not talk about structural dissociation but she does say that everyone is made up of child-parts and adult parts. She is working with me using a therapy called DNMS. She says it is a ego-state therapy. We are just working on creating my resources and strengthening them prior to starting the real work. My resources are a protective self, a spiritual self and a nurturing self. All of these selves have been instances in my life that I was able to embody those parts of myself so when digging deep into therapy I can utilize those parts of myself to nurture a part of myself that did not have it's needs met or at least that is what I feel the therapist is getting at.

I dissociate a lot and did not realize the extent of it. I am able at times to be aware that I am slipping but other times it just happens under stressful situations. As a child I thought I could fly and remember seeing my siblings on the ground and wondering why they would not fly with me. I had a significant amount of physical, mental and I suspect sexual abuse by my uncle when I was a toddler which I have no recollection of. I do think dissociation can be a good trait. I had a bad burn on my hand and I had to go to the hospital. On the way in the car I knew I needed to take my rings off so they would not be cut off as my hand was swelling. I remember when I pulled off the rings all the skin came with it and I was able to just shut off my pain. When I finally got to see the doctor at the hospital the doctor had to pull off all the skin. I do remember being in significant pain and I remember concentrating and being fascinated that the doctor was wincing while she was pulling off all my skin. You could tell it was really bothering her. It was incredibly painful but I managed to keep it contained. I had 2nd and third degree burns and went through weeks of having to have skin removed. I am glad my mind at times can do this.

I grew up never feeling like a child because I always had to protect my mother but at times feel like I am completely in a child mindset in how I react to things etc. I do worry that I will have difficulty with the therapeutic process because I feel detached talking about most things. Sometimes I have an emotional reaction but most cases I am just numb.

I had an interesting conversation with a nurse at my doctor's office. I was telling her about my little boy and how he has such a hard time with needles or going to the doctor. She was telling me that her grand-daughter does as well. She said she was recently at a nursing event and they were talking about body memories and how children should receive a topical analgesic prior to injections and other painful medical procedures. Her grand-daughter was a preemie and my son was as well. My son has so many sensory issues. She said that all the pain all these babies had to endure in NICU's has to affect brain development. I agree with her. I never got to hold my preemie twins for several days and they had needles and tubes everywhere to keep them alive. It is a very interesting theory and would explain my son's anxiety around anything medical.

 

[Hope4Now]

Maybe if I keep pouring chocolate into my head? Don't new neurons require chocolate?

Definitely. :)

 

[Friday]

Suppose some subset of ADD (not necessarily with the H) is actually dissociation. The distractibility part is caused by switching, so it is not that one bit cannot hold focus in itself, it is that it goes off line, and another bit, who is not interested in that thing, comes on. When the original bit comes back on line it is STILL focused on that same thing, it never stopped. That is why lists work for some and not for others. If three quarters of you fundamentally doesn't care about the list, and a third of that doesn't even remember that there IS a list (because it doesn't have access to those memories.) That is different from what I take to be the usual understanding that there is a single motivational state and a person can't maintain focus within that state, although they have access to the relevant information and continue to want to be focused. Distractible is not a bad descriptor from the outside, but doesn't half do justice to the experience, and may just obscure the underlying problem.

Just for clarity's sake...
All 3 forms of ADHD have the H, per DSMV. It was altered from DSMIV to reflect that hyperactivity is always present, either physical / mental / or both, along with the other changes made in the new edition. Long lobbied for, damn near universal

As outlined...? It would be a misdiagnosis of ADHD.

Disassociation is usually present in ADHD (it's part of what makes hyper focus work in certain scenarios, as well a common component in transitioning badly, logic leaps/intense creativity, and a few other things... Turn on 150 TV channels. ADHD brains take in too much information, all the time, zoning out is both required for a break from that, as well as to make cognitive leaps attaching relationships to form patterns in what might otherwise look like static), but it's not DID. It's a small facet of a complex disorder. Just like there are bipolar like mood swings, but it's not bipolar disorder... And there are sensory issues, but it's not SPD/sensory processing disorder... And there are often constant arguments, but it's not Oppositional Defiant Disorder.... Et cetera.

Each of the symptoms may look similar at first blush, but the causation is entirely different. 3 people with balloon like bellies all have the same symptom. 1 is pregnant. 1 has kwashiorkor (a form of malnutrition). 1 has a tumor. 3 very different causes for the same symptom. 3 very different treatments.

ADHD shares symptoms with many disorders... But It takes the entire constellation to make a disorder. The symptoms have to be present, and causation has to be the same.

Just like PTSD. If the symptoms look like PTSD but are better described by adverse reaction to medication which caused hallucinations / aka the trauma & what they did in the face of the trauma was all imagined? Not a real thing that actually happened, and how they really responded in the face of it? It's not PTSD. It's one of the drug induced disorders. If the distractibility and hyper focus is caused by alters switching who is in control? It's not ADHD. It's one of the dissociative disorders.

 

[Powder]

... what I've seen with therapy of dissociation was a lot of focus on who or what is the person's core/self, restoration of it, and I don't think it's really applicable often; healing from the damage isn't the same as undoing the damage and physical changes by the damage...

I wish I could quote the whole post, as it comes from an empowered voice, but this bit is most of interest to me. Is there such a thing as restoration of core self? I'm curious. Wasn't It is always there, and never truly left? Wasn't I merely in the background, hiding, but pulling the strings, the wizard behind the curtain, all along? Healing isn't a reversal so much as bravely coming out of the closet just enough, or merging in front sometimes, from behind the curtain long enough to feel alive. I just want to feel alive.

So often, my presenting selves working on my behalf to mask the real pain and to interact with others in the world, had to develop a different opinion that what I actually feel. For example, when a bully called my sister names or my parents commanded certain beliefs that were hypocritical, my presenting self had to "fawn," to agree with and actually believe the bullies were right. This ANP went with the "might is right" others and played along. Meanwhile, I lost touch with the me in the background who, while not agreeing with the bullies, did not feel safe in making that feeling known to the part agreeing/believing. Thusly, In my core self emerging, I no longer go to church or support organized religion. This is because my core self did not grow up believing in religion/god. Only the agreeing ANP did accept and believe and go to church with the abusive parents.

My core self had no concept for god in religion, that was all the ANP's role and learning. When my core self began to tentatively come out into the forefront in my 20's, I felt it's depression, disengagement from others, and lack of faith in religion, society, or god or anything. Restoration of core self for me feels like starting over, re-examining, as Eleanor said, beginning to ask the big questions from the core self, and turning over in my mind, all the answers from each part of me, and listening to it, but being brave enough to be honest about what I really feel about it, even if that's just "empty-handed" and hardly coherent for anyone else. This might seem like mindfulness to some, but for me it is admitting my core self is at a loss, must start from the drawing board, and being fine with having nothing to say or perform from the core that means anything to anyone else. My own empty self-less, sad, having hidden too long, core self is fine with me now. I love her, silent and observing, unopinionated, and inexperienced as she is, my lost baby is loved by me. I nurture her and bring her silent dignity into all my memories and experiences. I carry her, as Jane Eyre did in her dream, through my darkest valleys and peak mountaintop spiritual experiences. She was always there.

There is no need to pathologize "structural dissociation" or the self or its healing. Rather, as soon as it is safe to do so, I believe people spontaneously self-reflect, analyze, evaluate, integrate and approve of self to the extent needed for more happiness, more relationship within Self in order to have more Intimacy with a desired other, if that other is more integrated. In so doing, they will uncover least approved parts for evaluation. Until a part is approved of, it will demand attention, even negative noticing.

In order to have more intimacy with my friend, my desired Other and to share some happiness together, I desire more internal integration, a more user friendly matrix from which to think and feel each day. Very simple. Even without a desired Other with whom to share bliss, I still have some desire for further integration in order to be able to experience and have access to emotions, opinions, judgments that are more consistent and predictable, user friendly. I am less triggered by my own selves then. Less internally triggered means more able to think and feel with clarity and more quickly. Less delayed, layered reactions.

Up until recently too much of a divided self made me feel too much like my abusers. Thusly, I am my own trigger, my own unending source of perpetuating my trauma and C-PTSD. With internal self-compassion and relating from the core to all aspects of me with love, I resemble my abusers less and less each minute that I love and recognize the experiences of all parts of me as important and as having something positive to offer.

Full integration is a theory and not a reality to me. It is not my goal. My goal is to as Joe Campbell says "pursue my bliss." Only the core self has the healing power. But all parts of me are like trees that grew directly out of my core, so integration is merely honoring who I am, what I have created, not putting myself into a state of restoration, as if I never grew these appendages. That would be denial.

What is healing for someone like me? I must define that for myself, and not worry what theory or the therapist says it ought to be.

My bliss is the healing journey, not the healed destination. As I progress, I feel more myself. That's fine with me. I'm remembering my trauma and dissolving amnesic barriers. I recall the bad things I lived through, but as I do so, I'm not retraumatized because I am loved by me, for all of me. There is nothing I'm going to find that I did that I will reject. That is my belief. I am a self-accepting healer now. More and more of internal judgments, as they are found, will be transfigured into self-knowledge and self-acceptance, even self-compassion.

What is retraumatization for me? Continuing to abandon myself or to perpetuate or vivify the core issues within my trauma or abusers. Blaming.
Most traumatic to me was when my core inner child went into hiding. However, This apparent self-abandonment for survival of my psyche is now a beautiful mystery to me, and I am in awe of my own ability to orchestrate my own hiding and re-emergence. I honor myself for this. Even as I would honor a child who wisely went hiding from a predator, I would also honor her for waiting to come out until it is safe to do so. Likewise, I am proud of her for doing that and speaking her disgust with her abusers and abandoning them instead of herself/myself. Finally, I am proud of myself for bravely letting my core self lovingly expand to include each and every experience I have had, every response, and every choice I have made as having been done in my own best interest at the time. No more survivor's guilt.

I did it to live. I lived to get to this moment. In this moment, I choose to love all of me. This is my healing moment of truth and love. I cannot be anything other than what I truly am-it is impossible to truly abandon myself, therefore, I should stop believing that I ever really did. No more self-blaming for how I "got like this."

Belief A: Even as I am, I am unconditionally worthy of my own love. In my imperfection, I am perfectly loved by me.

Belief B: I will continue to uncover and remember more traumas and my 4F responses to them, some of which I would not be proud of if I were not aware of Belief C.

Belief C: All my reactions to trauma were necessary and are therefore, not subject to Good/Bad judgments. Therefore, there is no point in judging my responses in the 4F's as if they were character choices or conscious choices. They were not. The 4F responses reveal nothing about me other than that I am indeed human and subject to natural laws. This is where theory traces the trajectory of those laws, the limits of a body-mind in trauma. Theory offers understanding, a vocab. and objective validation.

Belief D: the more of myself (all of me, even memories, EPs that feel "not me") that I fully love, understand, and accept, the more I can heal. {Seeing is a good analogy} It is like seeing myself with internal/emotional contacts on and saying "Wow, you are actually beautiful in your own way!" This is made more easy when a good enough, trusted Other also says "You are always beautiful to me." (I hope my husband loves my core self, and not an ANP!)

Legacy Belief: I was born and will die in the fullness of my true self, no matter what happens in life between. What I do in life-between is a mere reflection of who I really am. Life is not about finding, creating, or resurrecting my true self. Life is learning to see and love self and other, without being blinded by my own light or darkness, nor refusing to look at another's. Not living a fantasy, but not letting reality destroy me. Weaving a good enough self and life story.

Undoing is not possible, no way to go back and remove the experience or conditioning. Core self is marked by sadness, and this will be a life-long feature. No need to limit self-definition to that. Self is able to be grown and expand awareness beyond the self and live in relationship to desired Other. Happiness is shared, not owned. :hug: Gratitude, goodness, and happy feelings of love are woven into the sadness to create a symphony of lives. Life is not one long flat note of sadness or happiness. For me, Sadness, minor chords are a major theme. But it is not the whole Sonata. I bring happiness to others and share in it. I love from a place of knowing many emotions, states, and experiences.

Transcending the core self, sharing good feelings within all parts of self and then with loved others is the bliss. My low notes of sadness bring depth to the harmony of my new song with my far less traumatized loved ones.

The bliss I seek does not lie IN the core self and its restoration, but rather, like Jane Eyre, I carry my "lost baby self" with "me" into my future.

See also James Hillman's "growing down" concept. http://www.personaltransformation.com/james_hillman.html
A quote from this site:
"The acorn theory says that the "daimon" selects the egg and the sperm, that their union results from our necessity, not the other way around. This has huge implications. That's the belief of the myth, and we have to make it clear that this is a myth, not a truth. It doesn't have to be believed, and it's not a theory that has to be proven. It's a worldwide myth, and it's a way of thinking or reflecting about life. It's something you entertain to see what the story does for you. Plato said that those who think this way may find that their lives will prosper, meaning it's not a bad way to think. (James Hillman, emphasis mine)

 

[Eleanor]

I'm worried about retraumatization in the name of connecting the dots.

Me too. My T pretty much never brings anything up - just deals with where I am at, and whatever is "up" for me right then. We also do some "coaching" stuff and she will follow up on that, but only if I ask. So I agree it is better for T's of people who are functioning ok not to go "poking around" in their psyches.

If it ain't broke, don't fix it.

If there were a treatment for people with eyes that could not fuse an image, but the person managed to walk to work everyday, didn't even realize they have a problem, but they were at risk of in the future falling and breaking bones or getting killed by a car because they had no depth perception, wouldn't there be an ethical requirement for therapists to try to treat them?

I think this is exactly the kind of situation Kaia is thinking about. And ... it depends on the level of risk, the risk of the treatment and most of all the decision of the person. The first question is "does the T tell the person they've "got" this strange thing?" I'm a big advocate of informed consent, and my default is always that "more correct information is better" Those questions about "if you had... would you want to know?" I pretty much always answer yes. Control freak in me, I guess. Back to the point - NO I don't think there is an obligation to treat. To the contrary I think there is an obligation NOT to treat without informed consent. But that's me.

Don't new neurons require chocolate?

Yes. Yes, they most certainly do. I am pretty sure there is good research on this. :D:bookworm: :cautious: If not. I think we should organize a study. Recruiting subjects shouldn't be a problem. I'm in. :angelic:

 

[Eleanor]

It was altered from DSMIV to reflect that hyperactivity is always present, either physical / mental / or both

Ah, hadn't put the mental "H" into it. Yup, I'll agree with that. Meditation teachers talk about "monkey mind" (sometimes "drunken monkey mind") I have always thought I had several monkeys.. a few of them do seem to drink a lot!

t's part of what makes hyper focus work in certain scenarios, as well a common component in transitioning badly, logic leaps/intense creativity, and a few other things... Turn on 150 TV channels. ADHD brains take in too much information, all the time, zoning out is both required for a break from that, as well as to make cognitive leaps attaching relationships to form patterns in what might otherwise look like static

I hadn't thought about the MENTAL in terms of hyperactivity before. Thank you for this. It explains why I can "speed research"... And why I am so good at pulling "signal from noise."

Each of the symptoms may look similar at first blush, but the causation is entirely different. 3 people with balloon like bellies all have the same symptom. 1 is pregnant. 1 has kwashiorkor (a form of malnutrition). 1 has a tumor. 3 very different causes for the same symptom. 3 very different treatments.

Also gluten intolerance. :sour: Point well taken. As someone for whom medication works quite well, but I can't take it a lot (it wears me out) I am always trying to sort out the underlying mechanism. No, obviously ADHD is not DID. But just as there is an "autism spectrum" there is a "dissociation spectrum" and as the DSM approaches things from the symptom side of the phenomenon it starts by grouping things by symptoms (hence the "diagnostic") which is how they present to physicians initially. But if these things are all physical disorders (insert long footnote about metal superveniening of the physical) then it may well be that the symptom clusters have subsets of physical causes, and require different treatments accordingly. Once we can look at a lot of brains in a non-invasive way we will likely get this sorted.

 

[greenleaf]

NO I don't think there is an obligation to treat. To the contrary I think there is an obligation NOT to treat without informed consent. But that's me.

There are probably whole books written on these ethical issues, recombinations of these issues are probably relevant in many medical situations.

Informed consent is definitely important! I bet it gets really tricky though... therapists might often not really know what the client's issues are completely until the issues come out! -- plus the client might be in a state where they will misunderstand certain phrasings of the issues... when I was a lot more intellectual-only in my perceptions of the world, discussions of emotional issues were at best lost on me. At worst, I think a buried EP sometimes might have pushed me to react pretty negatively to what would have been good relationships at times, way back in my past. Various other possibilities come to mind given how fragmented we can be. So "informed consent" is very very tricky here!

Luckily there might be some good things that should be helpful to everyone that a T might be able to work on no matter what, like trust building, grounding etc.

 

[shimmerz]

One of the differentials used for diagnosing ADHD is that if hyperfocus is not present (either physically or mentally) it's going to be a different disorder. Or condition.

Had to get back to this one. I am having a difficult time processing right now, so intellectual side not working up to par so please forgive if it shows in this posting.

Hyperfocus - My job, before my meltdown and from all other indicators throughout my life, had me reading 1000+ page manuals and picking out (very quickly) issues that related to my work. These were very complex issues. My job also included having to be at a client site (sometimes for more than 24 hours), troubleshooting issues or performing complex IT and networking tasks. On top of that I would read for pleasure. I multi-tasked regularly, juggling children, emergency work calls, house related issues, the list goes on and on. I was like a pit bull and would not let issues go. My list was excessively long and I have no idea how I was able to do what I did in a given day. I consider this to be a hyperfocus mode. Others may disagree.

Hypofocus - At this point I can't read a page of a book. I simply cannot troubleshoot anything, cannot deal with the simplest of tasks. Today, for instance, I was so proud of myself because I could actually call CAA to arrange to have my car repaired. I am simply not functioning and haven't been since D-day. Like a light switch, any remnants of my hyperfocus days are gone. Poof.

So yes, in my humble opinion, I have inherited ADD as I simply cannot focus on anything. I get that the DSM V has switched from ADD to ADHD, and I suppose they will switch the criteria the next iteration, so I don't put all of my faith in what the current diagnostic criteria is. This may not make my opinion on this very popular around here. Because of this, I am going to say that I have a form of ADD (without the hyper) as I seem to have the attention span of a gnat since this all happened.

 

[Hope4Now]

Hypofocus - At this point I can't read a page of a book. I simply cannot troubleshoot anything, cannot deal with the simplest of tasks. Today, for instance, I was so proud of myself because I could actually call CAA to arrange to have my car repaired. I am simply not functioning and haven't been since D-day. Like a light switch, any remnants of my hyperfocus days are gone. Poof.

Wow, this sounds familiar...the shift from before to after. Mine the same, but my hyperfocus still comes in and out...mine has been more like erosion than a switch and poof.

@FridayJones and @Eleanor you might be interested in the lens on ADD/ADHD that Thomas E. Brown has. http://www.drthomasebrown.com/ I admire his work a lot. He is one of many who fought hard to have the diagnostic criteria for ADD/ADHD as it is presented in the DSM-V expanded to include executive function. They lost. Broadening the concept of ADD/ADHD to executive function issues would have gone a long way to help people better understand the massive implications of ADD/ADHD on people's functioning. Of course, it's complicated because other things can massively impact executive functioning as well...like PTSD! (one of the areas of executive function is the management of emotions). There's no easy answers here.

There are still currently three types of ADD/ADHD: with hyperactive, inattentive, and combined (and many studies have shown that even people with the inattentive type have subtle physical cues that would indicate some level of hyperactivity. They've also shown that as people mature, they can shift between these "categories" so they are not exactly fixed in time). The DSM-V opened up the diagnosis a little bit to reflect some of the research on executive function, but it is still pretty vague. We'll see what happens on the next go-round.

There is a computer based assessment of attention (the TOVA) that is a pretty interesting diagnostic tool, and is being used with increasing frequency to assess attentional disorders and also to assess the impact of medication interventions. It is quite accurate in measuring attention over time. It does not explain the causes of the attentional problems.

Oddly enough, the arguments for expanding the definition of ADD/ADHD for the DSM-V were strikingly similar to the arguments for including complex-PTSD in the DSM-V. Reading about the politics that lead up to what ends up in the DSMs makes one question the usefulness of all the over-categorization and differential diagnoses. Yet as much as I question it, there is also part of me that longs for a nice clear-cut definition of my current issues...hence I keep on reading and trying to put it all together in a way that makes sense to me. It's been the same over my years of working with students who struggle in school...none of our human problems seem to fit very neatly into the DSM. But it does help frame thinking if we don't get caught in the frame.