Has Anyone Conquered Dissociation In Therapy?

[barefoot]

Thanks @amosmorris
Sorry to hear you're struggling with this too at the moment. It's certainly frustrating, especially when you feel as though you're taking steps backwards at times.

I was talking about the issue of honesty in therapy with my partner the other day. I think there is often a big gap between how I present and how I actually feel/what's going on under the surface. Sometimes I think my therapist "just knows" what's really going on but, thinking on it over the past few days, sometimes I do expect her to be a mind reader and sometimes I think we both end up in a bit of a guessing game with each other.

I'm going to aim to make a list of things where I think there may be discrepancies so that we can open some of this stuff up a bit.

 

[barefoot]

@Sandstone - I've started to do a bit of reading on ANP/EP. There are lots of references to DID and other dissociative disorders in what I've read so far. I don't have a diagnosis of any dissociative disorder and I don't think I have one - I just dissociate when I get overwhelmed with difficult feelings. Do you know whether ANP/EP still applies to me or whether it's more related to having specific "parts" (e.g. In DID) rather than say an inner child, which apparently all of us have?

 

[Sandstone]

According to the theory of Structural Dissociation, PTSD is a dissociative condition by nature. It makes sense to me - we do split our trauma off from our every day selves. They would say that everyone with PTSD has one ANP and one EP, that is Primary Structural Dissociation. Then, if there is more than one EP, someone will present with complex trauma, DDNOS and a few others. Finally, they say, if there is more than one ANP and more than one EP you move all the way to DID.

I don't think I need any more than Primary to explain what I experience, though my T disagreed and that is why I'm being assessed at the moment.

There is a presentation at
Link Removed
which is a bit heavy going at the beginning, but gets clearer

 

[barefoot]

Thanks @Sandstone - that makes sense.

 

[barefoot]

Any other suggestions, anyone? Or are we all as stuck with this as each other?? ;-)

 

[Abstract]

Barefoot, I am in the stuck category so have avoided answering with my experiences! Listening with interest though and relating a lot to things mentioned here, Just going into the therapy room alone sets me off. Don;t even have to get near the trauma stuff directly. When I have then things get really messy very fast. Great suggestions here I must say, I hope things improve for you.

 

[amosmorris]

I read a bit of the pdf you posted and I can see how I am still early in this process...I have to say that this all I think requires 1) huge amounts of patience (which is so hard since I know we are all always fighting the shame) and 2) a really special therapeutic relationship. The best we can do is to keep returning to the therapeutic relationship as the place where all this needs to play out. Your ideas about honesty, about not expecting your T to be a mind reader....that's where I'm at too...and after thinking about this thread last night some I know I too need to go back next week more honest about just the insecurities I have in the relationship. The dissociation switch is just going to keep turning on over and over again, as it always has for all of us (as I only now realize about myself, frankly), unless we break through all those relational walls...at least, that's the best I can tell for now. It hurts and is frustrating. Keep going back, sitting with it, being open about it, name it....I'm going to try to do that too. I don't know if that's helpful but it's where I'm at too....I send many good, brave vibes to you....and let's be sure to share the little triumphs....:hug:

 

[ButterflyBean]

@barefoot, a few questions; you may have talked about this before in another thread, so forgive me for asking. First, can you recognize when your dissociating, and do you use any grounding techniques in session? Second, what does your therapist do to get you "back in the room", etc.? I know those are general questions, but I am actually a graduate student in counseling, so having that information might enable me to help you come up with more practical solutions. Also, this probably goes without saying, but I'm assuming you have spoken to your therapist about the recent difficulty, correct? What are her thoughts? I'm willing to have a private conversation in order to brainstorm with you if you'd like! I know that the therapeutic process can be extremely frustrating sometimes, but I want to encourage you to keep at it! I think you're doing an amazing job just in the fact that you recognize the problem, which is half the battle! Keep up the great work, and please, don't give up!

 

[joeylittle]

@barefoot - I don't know if this will help or not.

I have had challenges with dissociating in therapy, specifically when doing trauma processsing.

It was initially pretty tough, as I was just getting used to managing the whole 'talking about it' thing. I think I'm fortunate that my therapist treated it as an extremely normal part of the process.

After awhile, I got stronger and faster at grounding, managing my breath, and had a long run where I was present very consistently.

We got into a different area of the trauma and I found I was dealing with a different experience of dissociation - prior ones were agitated until I'd suddenly 'leave', but now I was just getting foggy and sleepy and then I'd be gone. So, it was new, and I learned different skills, and now that's better, too.

I won't be surprised if there's something else that comes along as a new challenge. And, it'll just be another thing to figure out.

Personally - I don't subscribe to the theory of structural dissociation, and I don't identify with an inner child in any way; so I'd disagree that everyone has one. I think these are concepts that are applicable to many people. I suspect there's also a percentage of those who choose to create an inner child identity as a creative way to work through re-parenting, or because they hear that everyone has an inner child so they should too. That's my observation.

In my experience, dissociation is tied to very overt, experiential memories. After I conquer the dissociation, there's usually a big well of emotion to deal with, and the memories become more intrusive/are more likely to cause me to have a flashback. That, too, can be conquered. Processing the trauma is happening throughout, and I believe I'm always just myself throughout.

 

[jedikit]

It sounds like the question you're asking is, "is it possible?" In my case, yes but it's a lot of exhausting work and I thought I'd be happy "kicking" the dissociation... but where I'm at on my path sometimes really sucks. I see a trauma SE therapist weekly for the past 1 1/2 years (CBT therapist for 4yrs, and a 1on1 yoga therapist for 1yr). The SE therapist tells me I am 180 degrees "better" from where I was at when I first started coming to her. I was totally checked out then, my body-there/mind-gone sorta thing. So I'm thrilled that it's THAT much of a visual difference to everyone.

However being present sometimes is awful when we get to working the trauma work. There are times I WANT to make myself check-out... and can't. I had a bad week a few weeks ago where the images, nightmares, no sleeping, hijacking, etc, was too-much/too-fast and I couldn't resource myself out. I ended up self-harming just to dissociate. Which for me, I'm not usually a self-harmer (5 times ever in my life). I told the therapist so now she won't let me do any trauma work, just back to working on stability and resourcing... ugh, done those to death! But with dissociation fading into better coping skills, I can't let my guard down on practicing resourcing. Every. Single. Freakin. Day.

Is it possible to beat dissociation? I believe so. My therapist tells me so. But I know folks like us who use dissociation as a coping mechanism for everyday life are just going to have to work that much harder than the rest of the population.

 

[recoveringfromptsd]

I had the same disassociation problem before i went to SP TDU, where as soon as we went anywhere need abuse, I would space out and shutdown, usually in seconds. Since my stay at SP I found I can talk about these things with in limits. But I have to have my grounding aid to do it (frozen orange), its still hard, and I don't feel well afterwards, but I can do it. For me it comes down to get better I have to employ some radical acceptance to get past my hypervigilance, and employ some distress tolerance. I know when I start PE therapy the only way I am going to be able to do that, which requires delving into the abuse, and talk about it, is the be able to tolerate the distress that results.

I hate that I have to do that kind of therapy, but I want to get better, and not have this stuff always making me crazy.

I have found at least for me the answer to not disassociating is to be grounded. For me not just when I get triggered, but to try to be grounded all the time.

I have prepared my home with grounding aids, and keep aids (frozen oranges) at places I am at often. When I go to some space that is new, I take note of items there that i can use as visual anchors to ground to. And even when driving I counted over and over and over to stay grounded when I had a FB.

The only reason I am telling you this, is because even before I went to SP, members here told me about grounding, and what little I could comprehend at the time helped a lot, it kept me out of the ER until I got to SP. And what your describing is much like what I had where I would shutdown just on the question of abuse.

 

[Tabbycat925]

My issue of dissociation disappeared when I introduced the new issue of emotionless babble. My poor therapist has to deal with me giving what she calls my "quick and very vague explanation of the events that took place" it's kind of like a blanket explanation. My biggest issue is I don't want to cry because crying takes me back there or at least that's what I've been noticing. I haven't overcome this but I hope maybe that can help you find some ground.