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multiplicity_archivesHello everyone
The reason we're unsure of our case manager is because of one time when our therapist asked us why we were so determined to hold onto the did label. We tried to answer her, basically we told her it was because we had finally found something that fit us, we knew we were here, there were many of us, etc. that is did by definition. Anyway, a couple of days later our case manager asked us the same question in the exact same words our therapist used. Given the fact that we know they have permission to talk to each other, and that they work for the same organization, we figure they communicate with each other on a regular basis. I believe they have paperwork that says they can. I don't remember if they do or not. The thing is, we trust our case manager and she sees a larger number of us than our therapist does, even though our therapist sees us once a week and the case manager only sees us about once a month. Or maybe it's twice, I don't know. At this point we don't want our therapist to know we're wanting to change therapists. We'll either work past the fear of it, or we won't ... If we don't, we'll be stuck with her ...
We have New Hampshire Medicaid, and also State Aid to the Permanently Disabled, which is cash assistance of about $600 a month. It might be a little more. Anyway, our award letter for our medicaid stated that to continue receiving it we had to have ongoing treatment at the place where we're receiving therapy.
*Thinking* ... You know, I believe it would not hurt, the next time we talk to our case manager, to ask her if there is another therapist there who works with DID patients. The case manager knows we're not sure that our therapist is a good fit with us.
The thing is, I think there is another therapist who works with DID, but he/she is not also a DBT therapist. I signed a contract that I'd stay in DBT for a year. I suppose I could break the contract, but I'd really rather not. I haven't been in DBT long. According to our therapist, we have borderline personality disorder. But anyway, we've heard that DBT doesn't really work for DID. We're not sure yet if it is helping us any. We know we like DBT group better than therapy sessions, even though our therapist is one of the group leaders.
We've jokingly said that she seems like another person entirely during group, and we wonder if she's really multiple herself ... she seems so much nicer during group. She's more serious and intense in one-on-one sessions.
But seriously, is it better to have not quite the right kind of therapy, with not quite the right therapist, or better to have no therapy at all? How do you tell when a therapy or a therapist is doing more harm than good? How long does it take to know if you mesh well, if the therapist is right for you? It's been since late November for us. We still feel really unsure that our therapist is right for us.
Distraida
The reason we're unsure of our case manager is because of one time when our therapist asked us why we were so determined to hold onto the did label. We tried to answer her, basically we told her it was because we had finally found something that fit us, we knew we were here, there were many of us, etc. that is did by definition. Anyway, a couple of days later our case manager asked us the same question in the exact same words our therapist used. Given the fact that we know they have permission to talk to each other, and that they work for the same organization, we figure they communicate with each other on a regular basis. I believe they have paperwork that says they can. I don't remember if they do or not. The thing is, we trust our case manager and she sees a larger number of us than our therapist does, even though our therapist sees us once a week and the case manager only sees us about once a month. Or maybe it's twice, I don't know. At this point we don't want our therapist to know we're wanting to change therapists. We'll either work past the fear of it, or we won't ... If we don't, we'll be stuck with her ...
We have New Hampshire Medicaid, and also State Aid to the Permanently Disabled, which is cash assistance of about $600 a month. It might be a little more. Anyway, our award letter for our medicaid stated that to continue receiving it we had to have ongoing treatment at the place where we're receiving therapy.
*Thinking* ... You know, I believe it would not hurt, the next time we talk to our case manager, to ask her if there is another therapist there who works with DID patients. The case manager knows we're not sure that our therapist is a good fit with us.
The thing is, I think there is another therapist who works with DID, but he/she is not also a DBT therapist. I signed a contract that I'd stay in DBT for a year. I suppose I could break the contract, but I'd really rather not. I haven't been in DBT long. According to our therapist, we have borderline personality disorder. But anyway, we've heard that DBT doesn't really work for DID. We're not sure yet if it is helping us any. We know we like DBT group better than therapy sessions, even though our therapist is one of the group leaders.
We've jokingly said that she seems like another person entirely during group, and we wonder if she's really multiple herself ... she seems so much nicer during group. She's more serious and intense in one-on-one sessions.
But seriously, is it better to have not quite the right kind of therapy, with not quite the right therapist, or better to have no therapy at all? How do you tell when a therapy or a therapist is doing more harm than good? How long does it take to know if you mesh well, if the therapist is right for you? It's been since late November for us. We still feel really unsure that our therapist is right for us.
Distraida
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no subject
Date: 2005-03-12 08:28 am (UTC)DID = DISSOCIATIVE Identity Disorder. By clinging to that label, you are clinging to the belief that the people in your head are nothing more than you dissociating to avoid or better deal with something. The very nature of DID means that there is no such thing as 'Us', just *you*.
Frankly, you should give a therapist a few months, which you have. Personally it's better to have at least some kind of therapy, as long as it is working. The only person who can know if it's working is you. You should know if it's working easily. You should have worked with your therapist to set out goals, and you should be able to see whether you are getting closer to those goals or not.
A clarification
Date: 2005-03-12 09:17 am (UTC)I know all good and well that DID != MPD. But the therapist uses the label in the DSM-IV-TR. She said we had to work on her terms. She said DID and MPD are the same thing. When we answered her, we told her that we were multiple, we knew we were multiple, and the MPD label was where all the pieces fit. She does not accept the MPD label, which is in the DSM-III.
We used her term ...
I think we have to resist using her terms ...
We need to use our own terms.
Anyway, it's only a disorder for us in that we have trouble with memory and switching inappropriately and at random.
Our stated goal for therapy is that we want to be able to present a stable front to the world. We don't want to be a singleton, but the world seems to need us to be able to give that impression to it. And even if we sometimes switch in public, it needs to be our choice and not just something that happens randomly. We'd also like it if we didn't get thrown out of places or stared at because of the behavior of certain people while front.
We told our therapist that we wanted to work toward a goal of cooperation or of working together, to present that stable front to the world. She said (read: she lied to us and said) that she would be willing to work with us toward that end, although we needed to be aware that sometimes integration just happened anyway. This conversation took place during our third session. During a later session, another conversation about integration took place, and even though her words were the same, it felt more like she was going to push integration.
Distraida-Marc and Haesa
Re: A clarification
Date: 2005-03-12 09:25 am (UTC)Damn right you do not have to work on her terms. She has to work on yours. SHE is being paid to help YOU. If you do not have DID, then she should not say you do.
As long as you make it clear you don't want to integrate, she shouldn't push it. Her goal is your goal, to have you functional. you don't have to be in perfect harmony with your therapist but you DO need to negotiate and share goals. Otherwise it just isn't going to work any way you look at it. Ask her about it. Being up front some times unsettles them *grin*
Re: A clarification
Date: 2005-03-13 05:26 am (UTC)We are Distraida
Date: 2005-03-18 09:48 am (UTC)Our system name is Distraida. We always sign our posts with our system name first, then a hyphen, then whomever actually wrote the post. Distraida is a Spanish word that means distracted. We used to have Attention Deficit Disorder as a diagnosis. Our Spanish teacher called us Distraida. We didn't like her and ended up dropping the class, but the name stuck.
Distraida-Marc
no subject
Date: 2005-03-12 09:43 am (UTC)As
Do you actually want a DID diagnosis under those circumstances? Are you seeking therapy for multiplicity, or do you want your multiplicity to be taken into account in your therapy for something else? As in, the multiplicity's not a problem, but if your doctor hears about things from more than one point of view, it might help her help you? (It's not unusual -- we know a couple of other people, in therapy for anxiety or depression unrelated to multiplicity, who disclosed to their therapists so that different people in the system could use the therapy sessions to give their view on the presenting problem. But those doctors took the multiplicity seriously -- yours has already demonstrated she won't.)
If you're in therapy so you can get the disability money, it might be wisest to keep your other people under your hat, take the DBT (if you or any of your people really have BPD, this type of therapy is supposed to be very helpful), take the money, and take
stuff
Date: 2005-03-12 10:14 am (UTC)distraida-marc
Re: stuff
Date: 2005-03-13 05:23 am (UTC)BPD used to quite frequently be laid on people who presented as multiple and in fact some professionals thought that most MPD diagnoses were actually mistaken and the clients really had BPD. Also, people who present with what therapists think of as attention-getting or histrionic behavior are diagnosed with BPD, and maybe they think your talking about being multiple is that.
There are all sorts of ways to manage your system toward the goals you mentioned. Maybe it's just best to stick with the program for your disability money until you can either find a therapist who'll work with you on your terms (good luck) or find ways to do it yourselves (not at all impossible).
DBT
Date: 2005-03-13 03:10 am (UTC)no subject
Date: 2005-03-12 08:33 pm (UTC)You can probably predict what I am going to say, as I wrote to you that I am someone who has taken great trouble to keep DID off my official label, which is autism.
I'd take the Borderline package. We have a Borderlinish girl as the second most common frontrunner, and those sort of issues can be quite painful. As far as therapies go, DBT doesn't sound as dreadful as some, it may even be helpful.
I know what it is like to have trouble with communication and selves-control within your system. We've had our share of trouble with that, and continue to, although funnily enough, the greatest inconsistencies show up within the context of therapy. I wish it were an ideal world where we could just sit down with someone and feel safe about discussing system disfunctions, and our sometimes extremely painful inner world.
Unfortunately, that just isn't the reality these days. According to the definition of the DID label, you are imaginary. Therefore, most therapists will try very hard to integrate you. We even saw an alternative one who didn't believe in DSM, and he STILL wanted to integrate us.
If you ever are free of constrictions and can find a private therapist, try Vera Riley in Guilford, Vt. She said she didn't believe in integration, and I saw no indication she was lying, but we just couldn't hack therapy about system stuff by then..it was too late.
We got brave
Date: 2005-03-18 09:14 am (UTC)We got brave and talked with our therapist. She asnwered a lot of our fears, and we are fairly certain now that we can work with her. Some of the others are now considering coming out to talk with her. Some who weren't before. So this is good.
Distraida
addressing the therapist question, though
Date: 2005-03-15 05:50 pm (UTC)I was reading your own livejournal and you said this thing which I think is the biggest deal:
Sometimes I seem to hold it relatively together during the session, but as I think about and try to process what went on during session, I just get worse and worse.
It's been hard for us to know how to figure out whether a therapist is good or whether therapy is helping. BUT I think now that the fact that that's been hard is a sign that it's not good and it's not helping.
If it's helping, it should be clear that things are getting better or easier or that even though you're pushing through and dealing with really hard stuff, there's something positive or healing about it. There should be some sense of release or of support, *in my opinion.* Your mileage may vary.
But what you said up there is to me the biggest sign that therapy ISN'T working.
I had this problem with my current therapist recently too. She said a bunch of things that I thought were really fucking stupid. And then when I tried to bring up something that was really triggering me about my kid (outside kid), instead of helping me deal with my own triggers and feelings about it she started making all these suggestions about how to parent him. Which really boiled my buttons. Because I fucking know how to parent him and I did half the things she said already and she didn't even ask and for god's sake I don't HAVE a bigger trigger than "getting unsolicited advice/suggestions from someone that I've put in a position of power." At least I don't think I do :-)
And I was going over it and over it in my head and I spent an hour writing about it all after the session and everything she said that was stupid and didn't help. And one thing that was good that came out of that was that I figured out some more of what I want from therapy and what I would have wanted her to say instead, and what kind of help I needed. But I was really pissed off that I had had to spend an hour processing it - and then I spent even more time on it and being mad and dealing with all those issues.
And then I realized that that was it for me. It didn't matter whether I was right that what she said was fucked up, or whether it was "really a big deal" that she made suggestions, or anything. What mattered, bottom line, was that I was spending a TON of my energy dealing with the session I had had, because it had bothered me SO MUCH.
In my case, I talked to a lot of people about it and wrote about it some more that week until I could articulate exactly what I wanted to say to her and what boundaries I needed to set. And I figured out stuff for myself like - okay, I'm going to spend no more than 20 minutes talking to her about these problems from our last session, and then she has 40 minutes to shape up, and if she doesn't shape up she's not my therapist anymore.
Because seriously, we put up with mediocre, hapless, non-helpful therapy for like two years from our last therapist, and paid $60 an hour to do so, and went into a ton of debt around it (which is a whole other issue, and had a lot to do with her bad boundaries too) and even if it had been FREE it would have been a waste of our time. Except that she was good with the kids. But the adults: total waste of time. (And even with the kids she did things like lose the pictures she took of Lizbeth's sand tray after she said we could have them.) And, you know... never again am I going to sit around and wonder whether I should stick with someone who doesn't really seem to be helping. My life is worth more than that. (continued....)
i talked too long
Date: 2005-03-15 05:50 pm (UTC)In my case, with the current therapist, she actually heard and understood all the problems I brought up, and shaped up immediately, and passed all my tests, which is awesome. And it was great practice for me in setting boundaries and stuff and standing up for myself. But, of course, that won't always be the case.
The other thing is that part of the problem for us, and it sounds like it's a problem for you too, is not knowing how we feel about stuff. The thing that helped me with that actually wasn't therapy at all... I mean, I think that the therapist eventually WILL help because I specifically looked for someone who could do somatic (body-centered) therapy and help me feel the emotions and whatever that I've trapped in my body and blocked out (which is almost all of them!)... but in the absence of decent therapy, what's helped me know what I want and what isn't helping and how to deal with stuff has been 12-step work. That's another "your mileage may vary," but it might be a good thing to check out - something like SIA (http://siawso.org) (which has an online meeting (http://leaves.wineberry.net/sia/online) that i help with, and is very familiar with and open about multiple stuff ime) or CoDA (http://codaws.org) which is really great for boundaries and has helped us work together much better as a system, might be a start. 'Cause, you know, it's free!
About Therapy
Date: 2005-03-18 10:00 am (UTC)Distraida