DID Roles (ADULT CONTENT)

When I first learned about DID, I knew it from schooling. The old DSM IV name. Multiple Personality Disorder. Movies like "Split", "Me, Myself, and Irene", "Multiplicity", "What about Bob", "Girl Interrupted" (Peripherally, at least... Borderline is close), "Playing by Heart", "As Good as it Gets" (identity concepts), spy movies, serial killer profiles, and movie star references. It's not a flattering dx. As one MIP shrink liked to say, it is one of the hardest dx's to treat. It does not respond to medication. Not well. It is not a Gold Star. It is not a badge of honor. It it associated with so very many problems starting with Body Dysmorphic, running through substance use, down past highly dangerous behaviors including self-harm (a hallmark) ... sometimes I think it's the male version of Borderline. Shrink won't diagnose you Borderline if you are male. They will put you in PTSD or Bipolar or Depression or if they have no other choice, they put you with the ones they don't know how to treat, the DIDs, then they label you an addict and a criminal and cast you out. You are now a user of the system. You are the incorrigible. The untreatable, with fantasy problems. They question your sexuality. They won't believe a word you say. You are their nightmare. Their demon. Because they can't treat the causes and they don't want you to exist. You are the darkness, the shadow, the demon in their mind. The one they can't treat. They think of it in overly simplistic terms and prefer to use the word Psychosis. That is their Psychosis, their demon. The DID haunts them, because they cannot cure it.

People with DID or trauma respond best to Psychedelics. Just like Woodstock, except there's a new name for the trauma. Vietnam is gone. I've never tried LSD, PCP, MDMA, or Psilocybin, but some of these are being studied or even in trials. I have tried THC, ketamine (Matthew Perry OD), and Spravato. I have never tried Propofol (Michael Jackson's OD).

The fact that I have been to the hospital from "Girl Interrupted", the fact that that movie has Borderline in it, the fact that I have DID, the fact that they are both Dissociative/Trauma Disorders, the fact that it is hard to treat, the fact that it is patterns programmed from the past, the fact that it involves memories, symbols, and songs generated from the past, that it revolves around key event and circumstances, there's so many facts about DID that cannot be denied, that clearly connect to clear and powerful details of a persons life... It is the Psychiatrist's demon. It was Prichards' demon. It haunted him. Right up until the Governor's office stepped in. Now he is released. Now it haunts him no more. 

DID is about trust, about self-image. It is the reflection in the mirror, it is a name, and behind those things are memories and pasts, things that medication and medical intervention do not solve. 

They called it by other names. First, I tested PTSD off the charts at Clarity. Then a licensed PTSD counselor confirms independently. Then the Psychiatrist started talking about dissociation, then the therapy, then it's medical PTSD, then changes in the scripts, then the Dissociation Inventory at the new LPC, who independently confirms PTSD... and what did the hours long test results reveal? PTSD OFF THE CHARTS. DISSOCIATION OFF THE CHARTS. THE SCORES WERE SO DAMN HIGH AND HOW DO YOU FAKE THAT STUFF? SOMEHOW PSYCHOSIS CAME UP ZERO. ZERO. ZERO. HOW DO I FAKE THAT STUFF? DOES PSYCHOSIS JUST RUN AROUND MASQUERADING AS SO MANY DIFFERENT THINGS? YALL MADE THE DAMN TEST.  AM I THAT DAMNED INTELLIGENT? YOU'VE HAD EVERY SHRINK WITH A NAME UP THE EAST COAST LOOK AT ME. ONE OF YOU GONNA GET THE DAMN PICTURE? YOU SO SMART? A LITTLE GIRL FROM GEORGIA COMES OUT AND SHOWS UP YOU HARVARDS, YOU GONNA DESTROY HER NOW? YOU THAT DAMNED INTELLIGENT? Oh, no, some people think they know everything. Oh, they're big shots. On TV. They got their pictures on walls. Pricks.

You bring me out of a coma at Memorial, another at Beth Israel Deaconess, and you do it for this? Freaking Psychiatrists.

I still remember the machines. I was Frankenstein on their table. Whether it was ECT's Lightning bolt... 3 series, unilateral, bilateral, ZAP. I have phantom sensations on my head where they put the conductor. Then rTMS. Side of the head. Left side, generates nerve growth... Machine gun taps... Right side, calming suppressive waves... slow the neural transmissions... woodpecker... tap... tap... tap... tap... sharp... I can feel the tingling... 

ECT makes it go away! BUT IT COMES BACK! IT TOOK CARRIE FISHER. Psychosis my ass. Bad psychiatry. 

Then the VNS... electrical pulses from a pacemaker style battery up the vagus nerve into the base of the brain... activating pulses to encourage autonomic changes...

Before that it was the antipsychotics... Haldol, Thorazine, all the atypicals plus the first of the atypicals, the magical clozaril with its high maintenance and forest of physical degradations to the body, before that the mood stabilizers, the lithium, before that the stimulants and anti-depressants. 

Oh it never ends with these doctors. I've switched mostly to PA's and NPs. Medication destroys your mind and body both. A little at a time or all together.

Sometimes When We Touch (signals)

You ask me if I love you

 

And I choke on my reply

I'd rather hurt you, honestly

Than mislead you with a lie

And who am I to judge you

On what you say or do?

I'm only just beginning

To see the real you

And sometimes when we touch

The honesty's too much

And I have to close my eyes and hide

I wanna hold you 'til I die

'Til we both break down and cry

I wanna hold you

'Til the fear in me subsides

Romance and all its strategy

Leaves me battling with my pride

But through the insecurity

Some tenderness survives

I'm just another writer

Still trapped within my truth

A hesitant prize fighter

Still trapped within my youth

Sometimes when we touch

The honesty's too much

And I have to close my eyes and hide

I wanna hold you 'til I die

'Til we both break down and cry

I wanna hold you

'Til the fear in me subsides

At times I'd like to break you

And drive you to your knees

At times I'd like to break through

And hold you endlessly

At times I understand you

And I know how hard you've tried

I've watched while love commands you

And I've watched love pass you by

At times I think we're drifters

Still searching for a friend

A brother or a sister

But then the passion flares again

And sometimes when we touch

The honesty's too much

And I have to close my eyes and hide

I wanna hold you 'til I die

'Til we both break down and cry

I wanna hold you

'Til the fear in me subsides

Musical Diagnoses

Well, the hospital talked to the doctor talked to the internist talked to the counselor talked to the... wait? What's on the chart? Let's see...

Blood Pressure, 135/84 (Not bad!)

Pulse 68 (Great!)

Weight: gained a couple pounds back

Problem List: (This is the funny part)

Annual wellness exam (As if that is useful)

Long term use of drug (they're called prescriptions. You wrote them)

Chronic midline backpain without sciatica (as if that is unusual)

GERD (from taking clozaril and eating too much plus stress)

High risk medication use (kinda repetitive)

Severe episode of Recurrent major depressive disorder, WITHOUT psychotic features)

Sleep apnea, Obstructive (I don't sleep so good. Thanks, Clozaril weight gain plus stress)

Deviated nasal septum (from an impact)

Chronic Idiopathic constipation (gotta love this terminology)

Auditory processing Disorder (Don't hear so great)

GERD with esophagitis (As if that wasn't mentioned above)

Treatment resistant DEPRESSION (they keep inventing new types)

PTSD (Still here)

Mental Health Problem (Gotta love this one. I didn't want DID on the chart so they made one up)

Prediabetes (Another diet thing... though I'm barely in the range)

NAFLD (Nonalcoholic fatty liver... stress and clozaril)

Internal Hemorrhoids (The problem everyone wants to know)

Hyperlypidemia (This one seems new)

Weight Loss, unintentional (And here they state the obvious)

Chronic nausea (Thank you, stress and ADHD meds)

Psychosis (This one pops up from time to time)

Bipolar episode, current episode depressed, severe, with psychotic features (make up your mind)

Autism Spectrum Disorder (Here we go again)

ADHD (The first one I ever got)

BMI of 27-27.9 (shrug)

Annnnnnnnnd... down to 5 meds. 2 depression, 1 PTSD, 1 Blood pressure, one non-benzo anxiety)

Annnnnnnnnd... they're finally getting my name right.

Annnnnnnnnd... thank God no new referrals... Talk to the counselor to the internist to the GI Doc.

The one thing we decided for sure is that if I'm in the hospital again MIP will call me by the name on the chart or the guy with the name that rhymes with tent and the people above him will be hearing from me. Changed my emergency contact. Signed the new consent forms to coordinate care. So now the Psych can talk to the counselor who gets all the paperwork anyways and knows this is a bunch of bullshit that doesn't need fancy terms to describe it. I was raised by hospitals. This is the end result. Fathers were doctors and mothers were nurses. And now I'm here. With a problem list. And no ADHD meds. Cuz they suck.

Back in two weeks.

I am numero ocho.

Intrusive Thoughts (KPD)

 They started describing it alternatively as obsessions, bizarre thoughts, Hallucinations, voices... finally it drifted to intrusive thoughts and occasionally back to hallucinations, depending on the source. If it's past related, it's generally called voices, flashbacks, dissociations, or intrusive thoughts. If it's substance or medically related, it's voices or hallucinations. If it's present time related, it's the obsessions or bizarre thoughts. 

Intrusive thoughts are generally related to past experience but are triggered by things that happen in the present. Anything sensory that triggers a past association. My most common ones are seeing or hearing people from the past or seeing or hearing the same stimuli from the past. MIP. So many intrusive thoughts can come. Unfortunately, I know every square inch. It all has memories.

Now it feels like intrusive checking. The same people with the same judgments and concerns coming back for more. The Psychiatrists and relatives... the first rather reluctantly, the second rather addictively. Now I talk to a P.A. The mere fact that he does not qualify as a "psychiatrist" seems to console me. They move codes and labels around on a chart with their medications and talk about substances like it's their religion. 

The checking feels like a colonoscopy at times. Always looking for a polyp. So far, I'm signed up for weekly colonoscopies. I pass enough of those, maybe I'll get to space them out. I guess the LPCs will consult with the Psychiatrists, Social workers, nurses, MDs and others, and they'll come back to me with a plan on that. Maybe the Techs will get a break. The professionals alternate from annoyed to amused. Particularly the Internist's office. So, I space out my words. BP's remained within slightly elevated but normal limits. So, I continue the non-medical intervention: diet and mild exercise with stress management. The only Psychiatrist I can manage to take seriously at this point is the one that is/was assigned to work with the PA. That and care coordination keep him within that circle of trust. Every psychiatric guideline in my head resonates from that Psychiatrist and PA. To me, Bipolar is a rich shrink's pipe dream. It's such a vague and elastic concept that you could throw it at a wall and it just might stick. 

Maybe I'll add a dx to the DSM V. Under personality disorders. We'll call it Knowitall Personality Disorder (KPD).

Diagnostic criteria:

1. Habitual need for checking

2. Extensive knowledgebase

3. Inability to quit

4. Does not qualify for an obsessive disorder

5. Extreme need for categorization

6. Excessive attention to detail

7. Inability to shut mouth

8. Robotic communication

9. Excessive recordkeeping

10. Fails to take vacations

11. Maintains licensure when it makes no sense to do so

12. Condescending demeanor, with or without obnoxiousness

13. Intolerance for lesser beings

14. Lack of Hobbies

Exclusion criteria:

1. No four degree or higher or equivalent.

2. Has attended counseling voluntarily

3. Attends religious services regularly

4. Does not have a history of substance use