Pathological Dissociation? C: Week 48

So, here I am playing catch-up with the C sessions here, thanks to my recent laziness and endless forays into procrastination.  Let me add an advisory preamble to this post: I’m afflicted right now with a terrible dose of Blog-and-life-inertia-itis, so don’t expect this to be remotely scintillating, like several of you curiously found Sunday’s update to be (thanks, by the way! Sorry I’m toss at responding to comments at the minute but that’s the devious, underhand work of the Blog-and-life-inertia-itis again. Is there medication for this condition? Actually, yes, there probably is – Pro Plus, decent coffee and Red Bull. But if I self-medicate with those, then I’m hopping back onto the insomnia merry-go-round that I’ve been trying to get off, requiring more and more sedatives. So maybe that’s not as good idea. Just like it’s not a good idea to ramble ((and ergo procrastinate)) endlessly within parentheses).

The Blog-and-life-inertia-itis is compounded by the fact that I’ve completely blocked out most of this session from my conscious memory. I remember how things started, and I remember how they ended. What happened in the ‘middle’ portion of the meeting is frankly anyone’s guess; it’s almost like the chunk of my brain where the recollective (yes it is a word) neurons pertaining to those 30 or 40 minutes were stored has been cut out with a sharp knife. Well, así es la vida. On the bright side, I’ve always wanted a lobotomy.

As far as this session went, with the exception of a few minutes at the end, I’m not sure how much it really added to what had happened in the last meeting and the one before that – how could I be thus sure, however, when I don’t remember what the sodding hell happened. We started with the usual crap of silence – he asks where to begin – I say I don’t know – silence, which in fact has almost become the subject a parody between us now.

C was the first one to cave in. I’d noticed a couple of sheets sitting on the coffee table that sits between us (where the hateful, cheap tissues are housed for when mentals ((or rather, ‘mental’ – singular – because of course I am his only patient *cough*)) start bawling their eyes out), and was interested to see him gesture towards them.

He explained that he had obtained dissociation scales to measure just how extreme my ‘general’ episodes of dissociation, derealisation and depersonalisation were, as well to determine the seriousness of the dissociative psychoses. He had two such survey things; one is a standard dissociation scale, the second a much more in-depth questionnaire. He had apparently initially hoped I could fill them in during or at the end of the session, but given the length of the longer one (218 questions or something), he’d decided it was best if I filled them in at home then just posted them back to him.

He then mused about when he might receive them back, supposing it would be Tuesday (tomorrow). I was surprised to learn that he does not work ‘there’ on Tuesdays or Wednesdays; I missed the opportunity to ask what, if anything, he does on those days, but if I had to guess, I would say those are research days as I am aware that he has been involved in research in the past at least.

At any rate, he advised me not to sell myself short in the questionnaires; he feared I’d downplay the severity of my symptoms.

“On the other hand,” he continued, “you obviously don’t want to exaggerate them either, so…”

“So go with my first instinct,” I finished, to which he nodded. “I’ve always been advised when completing psychiatric questionnaires that I should basically go with the first rating that my mind thinks is appropriate.”

He agreed with this and asked if I had any questions regarding why he wanted me to fill these in.

Of course, I did. “Are you going to use these to bin me?” I enquired.

For some reason he initially smiled at this but, seeing from my facial expression that my question was serious, he desisted from that with very quick effect. “Not at all,” he replied.

I asked what, then, he hoped to achieve through the exploration of my answers to the questions, and he said something about it being able to inform deeply the way we work together. Apparently it could give him great insight.

I filled in the two questionnaires that afternoon, but found mysef to be somehwat irritated by the way in which they scale dissociation. Both ask what percentage of the time you have symptom x; for example:

Some people have the experience of finding themselves in a place and have no idea how they got there. [Thanks for not patronising me there, questionnaire, thanks very much ineed].

Circle a number to show what percentage of the time this happens to you

0% 10 20 30 40 50 60 70 80 90 100%

(Source)

When it says “what percentage of the time” what exactly does that mean? All the time? Times when you’re unwell? In the above example, how can that possibly be 100% of the time – surely that’s impossible. If you didn’t know why you were somewhere every time you were somewhere, which is a state of permanence, then…no, fuck it, it’s too late in the evening to try to articulate what I mean properly. Just…it’s odd. I would have liked some proper context to these questions, and it wasn’t there. So I added a note for C stating that, and advising that in the absence of such information, I was answering the questions at face value – ie. assuming that “percentage of the time” meant all the time. In all probability, having done so may well end up minimising my levels of dissociation as far as these scales go, but all I could do was be honest within the framework I was given.

Two things concerned me about the longer test (the MID) in particular. Firstly, a cursory search online suggested that the MID is used to diagnose Dissociative Identity Disorder (DID). Even though I’m all but certain this diagnosis is not at all applicable to me, I worked myself into a panic and convinced myself that C thought I had it. Not that there would be anything wrong with having it, obviously, but given how much I don’t think it applies, it would create an incongruence between C and I if that were his opinion. Fortunately, I now see that the scale is used more widely than just in relation to DID; it’s also applied to measure borderline and PTSD dissociation, which of course is me right off to a tee. So hopefully C is on my wavelength after all.

The second thing to annoy me was that there are several questions that ask about how much you exaggerate your symptoms – either physical or psychological – in order to get attention (or variants thereon). I know C didn’t write the MID, but I nevertheless took this as a personal insult. Does he really think I am faking all of this?! On a more logistical note, even if I were, am I really going to own up to that to him, the very person in front of whom I would be faking (at least psychic) symptoms?! Now, in fairness, I’ve been known to exaggerate some physical issues, but never ‘for attention’ – at least, not in the traditional sense. I’ve done it only when I know a completely honest description of the problem would not garner the treatment required, as is quite typical throughout the NHS (at least in my experience). To the best of my recollection, I’ve never done it in relation to my psychological health – if anything, the polar opposite is more likely to be the case.

C had thought we wouldn’t get to discuss the questionnaires this week as he reckoned they’d have arrived tomorrow (Tuesday) and he wouldn’t be back in that office until Thursday (at which point I am the first person, other than his secretary I assume, that he sees), but I ended up posting them in time that they may well have gotten there today, thus affording him the opportunity to study them in advance of this week’s session should he wish to do so. We shall see if indeed that comes to pass.

Anyway. I’ve diverged from a discussion about the session to a discussion of dissociative scales, so let’s move back to where we were meant to be.

Eventually, for reasons I can’t particularly fathom because it wasn’t relevant to anything we’ve been discussing in-session recently, I mentioned briefly to C that I had been out the evening before with A, as it had been the anniversary of my meeting him.

C asked me how things were with A, which was a curious question I thought; I don’t believe I’ve ever led him to believe that things were anything other than good between us. Of course, as I was typing that last sentence I remembered that of course I’ve told C about what a cunt I’ve been to A at times (for example, here) so I suppose it wasn’t such an odd question after all. Anyway, I said that things were good and that “A takes care of me.”

Unfortunately, I literally said that “A takes care of me.” Not his real name, but A. I corrected myself and continued, thinking of it as nothing more than simple absent-mindedness, but C interrupted me and asked what I had meant by ‘A’.

“Oh, that’s what I call him on my blog,” I said dismissively. “I suppose it shows what a big part of my life it is.”

I was ready to move on and discuss something that might actually have been vaguely useful, but C started harping on my apparent allegation that “the blog had taken over my life.” He looked suspicious, which disturbed me considerably. My paranoid mind is now convinced – especially in light of the exaggeration questions in the MID – that he thinks I make stuff up, or that I exaggerate and embellish to a significant degree, to make things sound interesting here. I don’t think that’s true. Is it? I know I’m guilty of paraphrasing and perhaps not always describing things exactly as they happened, but isn’t that the nature of any subjective human experience? Am I fucking things up?

And here we hit the brick wall of nothingness. I don’t remember the next half hour to 40 minutes at all. I could understand it if I just forgot little bits and pieces or nuances, but I literally remember nothing. My supposition is that this is because – hurrah, you’ve guessed it – I dissociated it. I’m almost certain that I didn’t reveal any specifics to him as regards our ongoing subject matter of child sexual abuse, because I remember having a discussion dodging that later. But I don’t know what I did say. I intend to ask him on Thursday, because I can’t tolerate this blankness, longed-for-lobotomy or not.

The next thing I recall was telling him that I hadn’t really discussed the flashbacks I’d been experiencing with him the previous week, owing simply to the fact that we hadn’t had time (as the session was almost entirely spent discussing the hallucinations). There was a bit of (largely un-recalled) probing from him, and a lot of humming-and-haing from me, though I think I admitted that the flashbacks occur as if they were my ‘present’ and not my past. I’m sure he asked me something on that point, but – wahey – I don’t remember what it was. Well done, P.

Eventually, I admitted to the somatic symptoms that accompany my flashbacks and, indeed, that often stay put quite independently of them – the almost constant physical pain that has plagued me as part of this whole nightmare for the past few weeks. I think he may have asked me similar questions to those he posed in this session – namely, were the somatic symptoms in my genital region – but I don’t remember fully.

What I do recall is that eventually I told him my back hurt like blazes all the time, and that it’s especially pronounced during a particular recurring flashback. He asked in what way it hurt, and I responded by telling him that I had been forced to sort of stand against a wall and that that was what had caused me pain in that area.

Cue a lot of investigation from him as to exactly how I was standing and a lot of attempted avoidance from me. In short, this flashback is one wherein I was pinned to the (outside of) the garage wall, my knees bent forward considerably so that I was at the ‘right’ height and angle to suck Paedo’s cock. The pain emanates from the pebble-dashing of the wall pressing into my back, as well as being pushed against the wall with some force during each hideous thrust.

I managed to get out of telling C what went on, but he couldn’t understand what way I was standing during the incident in question, leading to much confusion. I was about to act it out for him, but found that I couldn’t bring myself to do so, and told him as much.

He said, “could you draw it for me?”, pushing a pen and a bit of the bland Trust-headed note-paper towards me.

I was surprised at the request, and ever so slightly horrified, but made some gesture of reluctant acquiesence, and drew a stick-figure me contorted against a wall in the aforementioned grotesque fashion. To my immense revulsion, C then went to the wall and physically depicted the stance I’d drawn myself in. “Like this?” he asked.

I nodded, and looked away, suddenly ‘back there’ for a minute or two.

Fortunately – or otherwise, depending on your perspective – this was at the tail end of the session and he couldn’t probe me deeper any further. He said that his supposition was that this particular incident was a forced incident of oral sex (no shit).

“But,” he added thoughtfully, stroking his chin. “I don’t think calling it ‘oral sex’ is an accurate term. It’s not sex; the word ‘sex’ implies consent, not to mention the ability to consent.”

I stared at him blankly, determined to give nothing away.

And that’s suddenly reminded me of one thing that happened in the ‘lost’ half hour: I remember repeating over and over again that “shagging one’s uncle at the age of five is disgusting,” and C reminding me that a five year old can’t consent, and my counter-protesting that I knew that, but that didn’t change my view on how disgusting I was/am and that no amount of evidence or rationalisation ever would.

Indeed, I now remember that I repeated the word ‘disgusting’ in relation to myself and what happened over and over and over and over again, then went into a self-vituperation of epic proportions for failing to employ synonyms of ‘disgusting’ in my speech, thus in turn failing to utilise the English language in a more creative fashion. Very rational and helpful, I’m sure you’ll agree.

Anyhow, discussion of the forced-fellatio-flashback completed (that even sounds like a dubious sexual practice), I was feeling physically ill and as if I were about to explode with a doom-filled internal energy. I joked to C that I was going to throw up all over him, and he joked back that he would dodge the vomit and catch it in the bin. For some reason the gentle banter calmed me slightly – but I was still in full-on crazy-mode.

As a consequence, I held out my hand in front of me, in order that I could measure how much it was shaking. This harks back to an incident when I was 15. The day after I’d found out about my ex’s colossal betrayal – an incident about which I must write one of these days – I was sitting in school, literally shaking from head to toe. At one point I noticed my extended right hand shaking up and down, like the Golden Gate Bridge shaking in an earthquake. Ever since, I have used that as a benchmark to determine my levels of overt anxiety.

It was shaking a fair bit on Thursday, but not unmanageably so. “That’s OK,” I muttered thankfully, mainly to myself.

I noticed C’s raised eyebrow, and explained what I was doing. I was delighted when he said that he’d seen me doing it before. I know he’d seen me doing it before, but it was the fact that he remembered such a small, meaningless thing about me that was so pathetically important.

I was further delighted when he described my facing up to the fellatio flashback with him as ‘brave’. He’d also said I was ‘brave’ in the last session, and I have to say, the fact that he thinks this makes my heart and mind sing like something out of The Sound of fucking Music.

Clearly, though, C does not know that his endorsement (if that’s the right word) has such a positive effect on me. He said, “you probably don’t like me calling you ‘brave’, do you?”

I nonchalantly responded that I “didn’t mind” the use of the adjective in reference to me. Oh, what a belier of truth I am!

I went on and told him that although I appreciated him saying that, that it really didn’t “fit” with what I felt about myself.

“I’m not brave in my mind,” I murmured quietly.

“Well,” he responded, rather definitely and slightly authoritatively. “I think you are brave.”

And for the second week running, I got an “all the best” as I left, which always makes my week. I’m still desperate for him to actually like me, which I know rationally is probably a silly pipedream. But his present extension of an arm of kindness comforts and reassures me, and I’ll continue to bask in its loveliness for some time to come.

Related posts:

1. Wasting Time I Don’t Have – C: Week 49
2. The Reintegration of the Traumatised Self – C: Week 50
3. Empty Voices and Empty Chairs – C: Week 44