On Validation and Rehabilitation

Adapted and expanded from a post to a Facebook group. Someone’s post there reminded me to talk about the need to be validated.
In a way, every mental health experpience is genuine, even those seen as done for attention, and being told you may have imagined your symptoms, isn’t helpful. I have various diagnoses which my family and some other people reluctantly accept after they noticed telling me I was a fake/attention-seeker/wannabe didn’t make me better and in fact made my symptoms worse (maybe that’s subconscious attetnion-seeking but really it doesn’t matter). Now just over the week-end, as you know, I was told by a support group that they doubt my diagnosis is valid and want a better one before I can come back. At first, that caused me to suppress my symptoms, but within a day, it caused my symptoms to get worse.

I think however that we do need some healthy skepticism from others, in the sense that they should validate our experiences but not turn us into our mental illness or accept our every behavior. For example, if people give attention only when you display symptoms, as some people in my life have done, this is a surefire reason for symptoms to get worse. It is becoming clear in psychiatry that, for example, even people with psychotic symptoms should be validated to some extent. Otherwise they will not trust their doctors and will not be willing to take antipsychotic medication, and with good reason. I have never been psychotic, although I’ve had some symptoms that headed in that direction. Even in that state, it took a doctor validating me before I was able to be medicated successfully.

I believe strongly in the idea that unconditional acceptance of the person (not every behavior!) is key, but this includes giving positive attention and being interested in the person as a whole rather than just their illness. This does not mean constantly asking when the mentally ill person is finally going to get a job, for example. Rather, it means being genuinely interested in their day activities and helping them find ways to make their lives more fulfilling. The mentally ill person’s wishes should be the center, even though they cannot be fully catered to. I used to hate rehabilitation, with its focus on the person’s strengths and capabilities, until I figured out that it is really about what a person wants to do with these strengths and capabilities.

Clarissa

Rules of Abuse Disclosure for Proper Multiples

Jay Young of Astraea’s web made some valid points about trauma/buse disclosure in “real” multiplicity in her comment on Brenda’s post. I’m not as witty as Brenda is, but here is a list of rules for abuse disclosure if you want to be a proper multiple.

1. Multiplicity is always caused by severe, prolonged, horrific abuse, usually sexual abuse and in most proper cases satanic ritual abuse. I know the Dutch association for people with dissociative disorders had in their newsletter an advice column in which the columnist said other trauma can cause DID too, but this is not apparent anywhere else.


2. For this reason, you must on occasion drop words like “SRA”, “programming”, etc. in conversations about your DID.


3. In the offline meetings of the Dutch DID support group at least, you cannot go into detail about your trauma, or you can if it was not bad anyway. I was actually pretty much expected to disclose some details of stuff I consider traumatic.


4. You must have particular triggers, such as SRA holidays or certain colors. You cannot say why these trigger you, but it’s no problem that you dissociate when such a trigger comes up. Other people constantly doubting your sincerity obviously can’t be a trigger.


5. Validating others’ SRA meories is of utmost importance, but if you’ve gone through more mundane trauma, no-one is required to validate you.

Katinka

So What Do I Have if I Fake My DID?

Feeling kind of weird. Just drafted a post in which I reviewed the criteria of histrionic personality disorder in relation to whether I meet them. This is what my therapist says that might be going on in the unlikely event that we fake the DID. Well, when looking really suggestively, I could meet just enough criteria for a diagnosis, but that’s not how diagnoses are supposed to be done, especially not personality disorder diagnoses. It’s got to be a pervasive pattern of in this case dramatization, emotionality and attention-seeking.

Of course, there are other thigns that could explain my allegedly fake DID. Factitious disorder, where a person fakes an illness in order to be seen as sick. This is more commonly seen with physical illness, but in DSM-IV, there’s a subtype with psychological symptoms being faked. No-one can say whether I have this. Like, I could, but people could easily question my motives. I’m glad that, in DSM-5, the psychological subtype is abolished.

Katinka

Commandments of Being a Proper Multiple

Here’s some stupid rules for being a real multiple according to the Dutch DID community. At least, it’s what we’ve been told by our so-called support group folks both online and off:

1. You can’t use jargon like “co-conscious”, “inner self helper”, etc. if you’ve not had your diagnoisis forever. This is not supposed to be familiar language to a person just diagnosed.


2. Even if you know you’ve got parts because you’ve established a fair amount of communication, you can’t walk into your therapist’s office saying you experience parts in yourself. In fact, you cannot have obvious dissociative symptoms. According to what I’ve been told, saying things happen to you but not quite to you, is not appropriate either (which is what I really came into therapy with).


3. You must’ve gotten into therapy with seemingly irrelevant symptoms like depression, self-harm, etc. Then it’s the therapist’s duty to figure out you’re multiple, but they can’t just straight out ask if you experience parts in yourself. On occasion, they can, but you must be completely clueless to the fact that it’s not normal.


4. You must have some doubts about your diagnosis, and you must fear that it’s all real. If you fear you’re fake, you’re obviously already a faker.


5. You must not switch too openly or demand switches be acknowledged, cause DID is something that’s supposed to be hidden. Keeping the dissociation hidden must be an end in itself. Note that you won’t get a diagnosis of DID if the diagnostician hasn’t seen you switch.


6. You must want to integrate.


7. You cannot have littles who write properly. You also cannot have littles who write improperly but on the right subforum, cause how are they supposed to know where to write? However, you can’t have alterrs write on the main forum either. Why else would there be specific forums for alters?


8. You must recognize just enough of what other DID’ers, who obviously all are not fake, say they experience, but not too much. You must be able to articulate your experiences in your own words, and others determine whether you use your own words.


9. You must have time loss, but how you’re supposed to know you have time loss, is unclear. You can’t just say you lose time when others come out, cause how do you know? You cannot say you don’t remember somethign when asked, because then obviously you could pretend you forgot. I don’t know how a therapist is supposed to realize you lose time if they cannot ask, especially given that implicit memory is often intact in DID, so DID’ers act like they do remember what other identities did.


10. In meetings, you must present as the host (with the birth name) at all times. You must be oriented to the present if you want to participate in meetings. On the other hand, you cannot actually be the person with the birth name, cause that person must’ve gone to sleep, been gone at an early age or be totally unaware of any others. How are you supposed to come to a DID meeting if you are clueless about other personalities?


11. You must have survived horrific abuse, but you cannot talk about it in meetings.


12. You must validate others’ every experience, but you cannot say you can relate.

Brenda

DID Support Group Solves Problem of Health Costs, Oh My

When are fellow patients/clients going to stop diagnosing each other? This afternoon I was rejected by a support group for DID that I’d been attending monthly for two years, because the others felt I made an off impression (I recognized just a bit too much of other people’s stories) and they required a better evaluation before I could be seen as an officially-diagnosed client and allowed back into the group. Isn’t that a professional’s duty not a fellow client’s? I mean, to diagnose a client and determine if further testing is needed?

It may be because I coome from the autistic community, where it is not done to diagnose other autistics and where people who strongly self-identify as autistic are just as welcome as those with a formal diagnosis. I can understand that this may not work for a group of traumatized people like those with DID, so I can see why the group demanded a formal diagnosis. However, I have an official diagnosis. It may not have been done exactly as should, but I’m pretty sure a therapist, if spending enough time with the client, can always diagnose disorders better than a fellow client.

Okay, I’m familiar with the Rosenhan experiments, where the patients did pick up who was fake and wo wasn’t but the professionals didn’t, but that’s assuming a patient sees their fellow patients more often than they see a therapist. For this group, this is just not the case. And it’s not like patients don’t have a bias when looking at other patients, while therapists do. I think everyone has a bias equally depending on what information they’re given. If patients could do diagnoses better than therapists, therapists could spend lots more hours on actual treatment, and it’d be way cheaper for the health insurance companies too. Wow, the Dutch support group for DID has found the solution for the raising healthcare costs.

Clarissa

Where Are the Technically Fertile Childless?

Hopefully not offending anyone. I wrote a post about grieving the child I will not have several months ago, but deleted it because it had some inappropriate content in it. I want to write about this subject anyway.

At the time, something in me had me write “and am not sure I want anyway” at the end of the title about the child I will not have. I don’t know why I wrote that, because really I’m a mother at heart. I know there are reasons I won’t have children, which I’m not going into now. What I want to say is that I technically most likely could have children, ie. have no reason to believe I’m infertile. This complicates the whole childless thing more: are you childless by choice or childfree if there are non-technical reasons you don’t have children? I once read this article in a Dutch women’s magazine in which women talked about being childless, and one was simply childless (not by choice!) because she’s single. Isn’t that just as valid a reason as infertility is? Note that fertility treatmetns are not for everyone. Not everyone would qualify to be an adoptive parnet either – I wouldn’t due to being blind. Yet there’s no support for this community, outside of a few Facebook groups that I hesitantly joined. I consider this really strange.

Esther

Aspies Think Verbally and Autistics Think Visually, or Do They?

On Wrong Planet, a forum for people with Asperger’s (and they claim all types of autism and neurodiverse conditions, but they’re a bit supremacist), there is a discussion going on about why Aspies tend to be verbal thinkers while those with classic autism tend to be visual thinkers. I replied on the forum already but wanted to muse on for a bit.

Here is the thing: Asperger’s criteria say someone with this diagnosis must have a normal to above-normal IQ. Most people tend to judge intelligence by verbal IQ. While obviously an IQ test tests both verbal and performance IQ, except when you’re blind like us, people who are thought of as intelligent tend to have a higher verbal IQ than performance IQ. It’s actually known (Michelle Dawson and others researched this) that autistics who are thought of as intellectually disabled, often score much higher on non-verbal IQ tests like the Raven Progressive Matrices than on the Wechsler scales.

Add to this the fact that classic autism requires communication impairments, often in verbal communication, and Asperger’s requires no impairment in language by early childhood. Verbal communication diffiuclties easily lead people to think visually. Conversely, people with an AS diagnosis often have difficulties in non-verbal communication (it’s one of the symptoms in the social interaction domain), so may more likely become verbal thinkers.

I don’t honestly feel that the verbal/visual dichotomy is of any diagnostic importance unless the other bullcrap about “functioning levels”, self-help skills etc. is tossed out of the criteira. It is, after all, too often thought that those with AS are different in many other respects besides being verbal rather than visual thinkers. If we’re going to decide that there are different autism subtypes, ie. a visual and a verbal subtype, then we ought to leave it at that and not presume other differences unless they’re shown to be inherently linked to verbal or visual thinking.

Clarissa