Posted by: Ram | 2003/02/16


Dear Dr Simpson
I have been diagnosed as having DID. I am dissociated all the time and obviously feel out of control. Sometimes momentarily I will integrate (and it is wonderful) however these times last for only a few minutes and then I dissociate again. At these times I am very upset and try to get back down into my body (the feeling is of being out of your body - actually very like being imprisoned in your body and not being able to get out). I have been in therapy for many years but was only diagnosed about 5 years ago. Is there anything that I can do to make me integrate. What is the procedure with other patients to bring about integration. (I also am scared all the time, suffer from anxiety and depression and many other things - these are apparently all only symtoms of dissociation).

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Our expert says:
Expert ImageCyberShrink

Dear Ram,
Sorry to disagree with some aspects of the diagnosis you seem to have been given. DID remains a very deply controversial diagnosis, which has in many cases been made without sufficient basis, and with very poor results from treatments which usually make the situation worse. In America, there has been in recent decades a whole epidemic of misdiagnosis of DID ( formerly MPD ) resulting from misdiagnosis by naive and obsessed "therapists", and treatments that were often disasterous. Several million-dollar court cases are wending their ways through the courts as a result, and some of the most formerly celebrated "specialists" in DID have had their licenses to practice taken away, and or had to pay large settlements.
I very greatly doubt the suggestion that anxiety and depression are "all only symptoms of dissociation", as there's no good evidence for such a point of view. Quite the reverse, dissociative symptoms, to the extent that they are naturally occurring, usually arise as part of a primary depressive or anxiety disorder, and respond best to expert treament of anxiety and/or depression.
Quite the worst thing that can happen to someone who may have dissociativ symptoms ( among others ) is for them to come under the care of someone with a very special interest in DID and dissociation ( such practitioners often see nothing else ) --- people usually do much better seeing a level-headed general shrink with a broad range of interests and treatment methods.
Among the treatments which can make DID much worse, are hypnotherapy, becoming involved in groups with other patients in whom DID has also been diagnosed, visualization and regression therapy, or any method that claims to help them recover memories of earlier trauma and presumes that there will be some such trauma to recover. If a "therapist" ignores your whole range of symptoms, and fails to concentrate on practical ways to deal with them in the here and now, I'd be woried. If a 'therapist" starts talking about "alters" and "personaliies", and tries to label and name each different aspect of how you happen to feel a different times, and asks to speak to parts of your personality --- I'd be very concerned.
Th best outcomes seem to come from seeing a well-rounded and sceptical shrink, who will treat you as a whole, rather than as a hole.

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Our users say:
Posted by: Zeena | 2003/02/17

I know I sound like a medical dictionary -- but during my teenage years I had those symptoms, and in later years, so did my very down-to-earth brother-in-law. To the best of what I now understand, like the Shrink says, it starts with anxiety/nervousness/maybe depression. In my case, my parents are no-nonsense people and to this day they don't know the hell I went through when those episodes struck. You feel disassociated from your body, yet you are still in it. I remember how once it struck me out of the blue on the streets of Stellenbosch ... You feel like a ghost, observing things, being not quite there, and you are really terrified, and try to act normally.

Very much later in life and for different reasons my GP prescribed tranquillisers, and I realised that if I had had them all those years before, I would not have suffered those awful episodes -- you are scared, your heart races, you feel "out of it" completely. It's as if the world is an alien place and you are dreaming everything.

So, Ram, yes -- get help, there is no need to suffer this.

Reply to Zeena
Posted by: OBSESSIVE | 2003/02/17

Years ago, I had similar problems -- it was so dark and spooky! My first question to you is, are you on medication? Are you seeing a psychiatrist or only a psychologist? (Psychologists do not prescribe medicine.) Medicine, and a lot of experimenting with it (which I did not like at first) finally brought me complete peace. Never in my life did I think that ANYTHING could overcome the awesome disorder I had, complete with huge panic attacks. After years of searching for the right medication, I woke up one morning after trying a new medicine, and ALL THE SYMPTOMS ALMOST MAGICALLY WERE GONE (after 15 years of pure hell)!!! Please also read my response to 'CLINICAL DEPRESSION." There is no way, in my experience, that you can get well without proper medication. The answer is probably already there, you only need to find it -- if you keep looking, you will! You can also try free clinical trials, if you cannot afford medication. I know how these disorders effect our working life. Contact a mental health organization for such referrals. My thoughts are with you ...


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