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Dissociation Diagnosis Issues Etc

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I think this is a needed discussion. Thank you.

I like the look at avoidance as a form of what we call dissociation, and as a deliberate action. I wouldn't call dissociation "learned," since the connotation is that it is not really done unless one goes out of their way to learn it, like Karate. Dissociation is not so much "learned" as increased from the baseline in a habitual way. Some people sigh at work when they face a daunting task; some drink more coffee; some listen to music; and, some dissociate when no other thing is at hand. Studies show that even people with no disorders will have rerealisation and depersonalization from normal but heavy work stress. They are in the middle of a project that will determine their whole career, and when they go home, they don't recognize the person in the mirror for a day and it freaks them out. So, dissociation is a natural reaction to stress; it is normal for it to be transient, but when a child grows up in survival mode due to long-term or severe, repeat abuse, dissociation along with developmental stages, mutates our development so that we dissociate more deeply and more often, and may even fragment our identity (in the case of DID) as a result. That is the theory. (There is a lack of consensus because we are still just learning about this, and ourselves.)

Maybe this is learned, and apparently psychologists do teach it to chronic pain suffers. Dissociation is adaptive behavior. In a sense, as we all do it, it is no more "learned" than breathing or walking. It is a tool we all have, but most of us use it only under extreme stress. Those who grew up under extreme stress regularly, do it more than others. That's all.

When I experience physical pain for more than a few minutes, I grow dizzy and feel like I'm leaving my body. This is, to me, dissociation, because I do not choose it. In fact, only since learning about PTSD and dissociation, do I accept that that's what I'm likely doing. I used to think everyone had this reaction.
From watching my reactions more, I'm noticing more that I hold my breath or breathe very shallow when in pain, whether that pain is emotional or physical. Even when I ran sprints in track, I was passing out after a good race. The trainer told me she was watching me run and that when I reached the last hundred yards of the 4x4, my diaphram stopped moving up and down, and she said "You're holding your breath." "Why?" I asked. She said, "I don't know," and just had a serious expression. PTSD includes holding your breath, during stressors, but when you also dissociate, it goes further. I have lost consciousness and just gone blacked out for several minutes under fear triggers that resembled the original traumas. Even though the situation was not as dire, it triggered me to stop breathing, but that is not why I lost consciousness (it is a learned thing- you just "go away," then I was waking up later. This is the most severe dissociation form, but it happens very seldom, even if you have it.
 
There are two words that I mentioned above, which I should highlight, as Muse's points can also be acknowledged by these key words, being "conscious" and "unconscious" acts.

Dissociation is sometimes "unconscious" (normal), though to correct the more destructive, negative forms of dissociation, as Muse actually eluded within statements, you can shift it to a "conscious" act which is how you control dissociation disorders.

That all can be summated by the technique called "grounding".

An actual example of people doing this, again, between unconscious and conscious brain activities, is when you are driving and you get from point a to b, then don't remember the trip as your brain has done it so many times it can do it instinctively, without thought, even though your awareness is actually present, ie. if something jumped in front of your car you would react normally... yet your normal trip also then goes from point b to c, you now intentionally (consciously) pay more attention to your surrounding, actions, weather, etc, all to keep your brain focused and within its conscious acts, because getting from point a to b without remembering it scared you slightly due to not understanding how it happened.

In other words, you dissociated between point a to b, yet you grounded yourself between point b to c.

That is a simple explanation of normal dissociation, followed directly by changing your behaviour to not dissociate.
 
Yes, I was not taught any grounding. I have read it here on the forum, but none of the T's mentioned it. I need to learn how I can do it. As I said above, I cannot do the counting thing, as when I dissociate, I cannot count (I think that's because I was young during the abuse, prior to school, but I don't know for sure). I can think, but counting feels very hard for some reason. Maybe it's supposed to be, but they make it sound as though it is relaxing or easy where I've read it online. I have used looking around at the environment and finding concrete proof that I'm 34, not 4, based on what I'm seeing. The fear that occurs makes it feel like I'm back in the trauma time.
 
Thank you Anthony. You read my eluding the grounding correct. I avoid talking about it, as I feel that this is what I'm missing, and that I will be spending the next phase of my life working on. And it is rehab.
 
I have used looking around at the environment and finding concrete proof that I'm 34, not 4, based on what I'm seeing. The fear that occurs makes it feel like I'm back in the trauma time.
This demonstrates that you are already trying to find what works for you personally. There is no one method.

It can be a quick, "shit, I am feeling like I'm going to dissociate, pinch myself, look around, stand up, etc" approach, or any method of approaches. Some people counting may work, some it won't. Some looking around may work, some it won't.

You normally need both a cognitive and behavioural response, being what you are doing, such as looking around (behavioural) whilst finding fact of age (cognitive and behavioural, depending on the fact found).
 
Yes, cognitive and behavior together seems to work. You show yourself that you can take action and your thoughts are registering that you are, therefore, you must be in control. It's almost a game. And really, it's amazing how we can train ourselves and just don't think we can until we do. Getting totally rid of the need to do this in the first place may take longer until we reach remission or cured, if that can happen. But even until then, this gets me through.
 
Scared of Lonely, are you still checking this thread? I just wondered if you have come to any conclusions about this point on PTSD and DDNOS.

You said you dissociated during therapy (not sure if with regular T or the program) and I'm wondering if that more than the written test, or maybe combined with a score, is the rationale. Whatever it is, you ought to have a right to talk to them and find out the basis. This is your medical file, and you should be able to have access to some more info than you got.

As to if you dissociate (I don't know to what degree: amnesia, blacking out, dizzy, or what level) during trauma therapy, does that mean you have DDNOS, I don't know and I do know that is not well understood. Some think DID is actually "induced" by therapy re-traumatizing you through forcing you to go deep into your trauma too fast without adequate grounding, trust with therapist, and so on. So I guess you might think about how they treated you during those sessions. I have also heard that if you do have DDNOS and finally feel safe with a therapist, you "let your hair down" with them, and the DDNOS or DID shows itself more with them. I also do not know about this theory, nor do the experts, at least based on enough research to convince a majority? I guess dissociation is hard to study, hard to make a test for, and is still just at the beginning. That may explain why you felt like a lab rat, and I could relate.
 
No dissociative diagnosis can be given when its caused / triggered within the therapy environment. Any such diagnosis that is given to a person because of their reaction in therapy, is thus null and void, extremely false and the therapist should have all qualifications removed.

Dissociative diagnosis MUST affect a persons life, which is not in therapy, that it causes clinically significant distress. That still excludes dissociating due to heightened symptoms due to therapy itself.

The dissociation MUST be present without therapy provoking a response. Otherwise, people would be walking around with an arms length of diagnoses due to the responses provoked from therapy.

That is the equivalent of making a person ill to diagnose them with another disorder. That is unethical and greed motivated in every legal and moral sense of therapy services.
 
Thank you for that, Anthony. I didn't see that aspect. Well, they spend 8-5 in that office, and that is what they see. What they see may seem representative, but it's not.
 
Muse, what works for me is that if I can recognize that this is happening I can pinch myself, concentrate on objects, use reminders of what (cognitively) tells me I'm 'here now'. And pay attention to your breathing.

When it has been the worst- SI present and likely constricted thinking, I cannot, for example 'remember' memories; I can remember people 'exist', and their relation to me, but have no 'memories' or 'feelings' that I can recall.
Times like those, 'staying put', and getting cold (outside) or very hot, or once I remember picking up a rock that looked like a bird and that started to jog my mind, oddly enough, or conversely just getting up and intentionally walking 'away' and 'towards' something else, say counting the cars in a parking lot, going into a busy mall, etc, seemed to help.

Yes, it seems 'weird'. :(
 
Hi. I have a question and I am new so not sure where to post it. I was wondering if PTSD must be diagnosed by a psychiatrist or someone like that, or if a GP can diagnose it or another health practitioner? does anybody know how they came to be 'officially' diagnosed?
 
Hi. I have a question and I am new so not sure where to post it. I was wondering if PTSD must be diagnosed by a psychiatrist or someone like that, or if a GP can diagnose it or another health practitioner? does anybody know how they came to be 'officially' diagnosed?
Anthony and others have threads on her about diagnosis. You can search the side in the search tool. In my opinion, a GP is not trained in the DSM criteria, so s/he can only suspect and refer. That is not to say, that person is wrong or didn't attend some kind of PTSD training seminar. They won't have the training to rule out other disorders, so nobody is going to accept their diagnosis as final, IMO. Again, this is an "Anthony" question. Sorry I don't have the answer on the tip of my tongue.
I was diagnosed 15 years ago by a psychiatrist as having PTSD. Subsequently, all other counselors and physicians accept his diagnosis, and that's due to the fact that he had the training to rule out other issues and make accurate mental health diagnoses. I hope this helps some, but do check the forum and do the search to find out if I'm right, because I'm not 100% sure. I would at least get that level of expertise for diagnosis and then try to find a therapist you trust for treatment. Some psychiatrists are not as good on follow up care and just push pills. Some are wonderful as therapists, too. It depends.
 
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