A Profound Psychiatrist’s Appointment

So we had a psychiatrist’s appointment today. Originally, our psychiatrist had asked to see our husband too, but he didn’t want to come. I was a little late due to transportation issues, but we still covered many profound topics.

First, we went into why our husband didn’t want to come to the appointment with us. The psychiatrist was careful not to let me speak through her for my husband or vice versa. I liked this.

Then we went into our treatment goals and why we’re going extremely slowly with the dialectical behavior therapy program we’re following. Our nurse practitioner had already explained that he’d like us to fully understand the concepts before moving on to the next chapter, so that’s why in three months we’ve not gotten beyond the second chapter, which covers core mindfulness skills. There are 24 chapters in the course. Normally, BPD clients in group therapy do one chapter for each session and so they can finish the course within six months.

I started to explain how I find it incredibly hard to apply the skills into my daily life. Like, there’s one skill called observe, which is intended for taking a little distance (without dissociating) from an overwhelming emotion. For example, you can start by observing what you feel or think without describing it. I thought an example of this distance-taking was to do arithmetic in your head. My psychiatrist says that’s a step too far, as we first need to observe that we’re experiencing an overwhelming emotion (or physical sensation). Then we can take a step back and decide what to do with it. I mentioned the physical sensation of needing to use the toilet, which commonly overwhelms me to the point where I can no longer act fully functionally. (Because I am blind, in most places, going to the loo requires me to ask someone to show me where it is, which requires communication we don’t have access to when overwhelmed.) The psychiatrist told me that, if I do observe this feeling on time, I can still decide what to do with it out of my Wise Mind (DBT jargon for the right combo of feeling and thinking).

Then we went on to discuss the “pieces”, as we call the alters qwhen our mental health team are around (as to avoid self-diagnosing). Our psychiatrist asked us to describe some experiences relating to them, like how many are there (around 25) and what happens when we switch. She then asked whether all of us could agree that there is just one body, whether we like it or not. This was a truly profound question. First, she had us clap our hands and asked whether any of us are still convinced they could use those hands to cover their ears and not listen to what she had to say. That didn’t work, as we still dissociated a little. Then, she held our right hand and asked the same, repeatedly. This brought on a ton of emotional reactions, mostly wonder. We couldn’t say much, but later, when in the taxi back home, some of us were like: “I may not be able to cover my ears w ith those hands, but I can still run from that psychiatrist. Oh no, I can’t, as she’s holding my hand.”

We also went into how to do treatment from here on. We sort of sarcastically said maybe it’s going to take us five years. Our psychiatrist said that, if we truly want to make this work, to count on it that it’ll take that long indeed. I’m not sure how we feel about this. I mean, when we first started DBT a year ago, we were told by this same psychiatrist to do one chapter every two weeks and finish in a year. Of course, we found out pretty soon that this wasn’t working and a lot of other issues got in the way, so we restarted about three months ago.

We’ll meet with our psychiatrist and nurse practitioner together someday in September. Our psychiatrist will then explain a little about how to go from here and then we can hopefully decide whether we want this or not.

At the end, the psychiatrist shook our hand and said: “Now I’m giving you (plural) a hand and say goodbye.” That was such a validating experience. It was good to be validated like we’re multiple minds but also contained in that we only have this one body. As a side note, neither of us ever mentioned DID or dissociation. We think that’s a good thing, in that we don’t need to conform (yet) to any diagnostic box. After all, we don’t “want” to be DID, but we are multiple whether we want it or not.

Movement Therapy Again

It’s incredibly hot (yes, it’s *still* incredibly hot) and I’m not too motivated to write. However, we had movement therapy again today and I feel pretty much obligated to share about it, since our last session didn’t go well.

I was feeling somewhat stressed but also capable of communicating my feelings at the start. I explained about having fought with the therapist about her asking for Astrid to come back. I just realized yesterday how unhelpful this can be on several levels. It’s not just that it creates a fight between us and the therapist. If the one who thinks she’s truly Astrid truly appears, she’s often quite disoriented. Yesterday she did after Marieke tried to be open about herself. I don’t know whether she’s truly the core or just a part who denies our existence. I like to view us as a system as altogether Astrid, but this Astrid part is clearly not us as a whole and can still feel quite dissociated. But I digress.

I told the movement therapist that I’d prefer her asking us to get back into an adult state if we seem to dissociate. This was fine by her, so when this had been cleared up, we could proceed with the session.

I disclosed that our mind was quite full of thoughts. Actually, it was several others chattering but I didn’t say so as to not start another argument. We then did a concentration exercise. We had to move a one-meter-long stick that was standing up from one hand to the other without dropping it. Then from one finger to the same or next finger on the other hand. This was quite a challenging activity and we liked it.

After that, we did a sensory activity with a spiky ball. I was out in the body but Marieke and Suzanne were close by. I chatted to the therapist while they felt and enjoyed the ball. After this, we did a ball-throwing activity. This was definitely calming and enjoyable. It helped that the others had already had their time close by the front, I think.

Creating an Inside Beach

Hi hi, I am Milou. I am 8-years-old and I have blonde hair. Earlier today, Allie wrote about creating an inside beach in therapy. I want one too! I really want to go back to Vlieland to see the real beach, but the bigs say I can’t. So now Esther is helping me create an inside beach. She put up real beach sounds on the computer for me to listen to.

I hear the waves. They are the North Sea waves. I love swimming in the North Sea. The bigs say I can’t go in too far.

I see the sun. It’s evening now that I write this, so the sun is going down soon. I love seeing the sunset. The sun is bright orange.

I can feel the sand under my feet. I can play in the sand. I like to build jellyfish castles. Yeah, that’s real, I add dead jellyfish to my sand castles. The bigs laugh and say it’s yuck. I can also dig a hole in the sand.

The sun has been shining all day, so the breakwaters (that’s what I’m told they’re called in English) are hot. You can stomp your foot in them and leave a footprint. You can also write your name in them with a pointy object. Read me write “MILOU”.

Oh, this was such a fun activity! Like Allie said, we can always add more to our inside beach. I can come play here whenever I want. Nighty-nighty from Milou.

Quote of the Day (July 26, 2018): The Way to Get Started

“The way to get started is to quit talking and begin doing.” – Walt Disney

This sure has to got to be the motto for this blog. And maybe for my healing journey as a whole. I may talk healing, but if I don’t work hard in therapy and such, I’ll not accomplish much.

This also reminds me of a conversation we had a few days ago with our husband. I said I miss talking to him, really connecting to him, like I did when I allowed my alters to be who they are. I thought my husband didn’t want us to be us. This isn’t the case. My husband told me to actually stop talking openness and connection and start opening up. That’s the only way to actually connect. And though that opening up involved talking, it also involved connecting on a deeper, more-than-words-can-say level. We loved it.

Movement Therapy Yesterday

Trigger warning: strong language.

So yesterday we had movement therapy. We feel it’s really helping but we also switch a lot during this type of therapy. We’re not formally diagnosed with a dissociative disorder. Were formally diagnosed DID but that got changed to BPD five years ago. Our current mental health team’s opinion is that the “pieces” are allowed to be there but there’s no need for a dissociative disorder diagnosis or any form of specialized treatment. We do DBT individually with our nurse practitioner (not in a group because we’re autistic and would be overwhelmed by a group) and the movement therapist tries to incorporate some DBT too. We really try to fit our “pieces” into the DBT model of emotional/rationa/wise mind (we purposefully avoid the word “alters” as to not suggest we self-diagnose, as our former psychologist believed we made up the DID).

The thing is, Astrid is rarely out. That is, always when we think we’ve found the core or “real” Astrid, we realize it’s yet another alter. We don’t mind as most adults can present as Astrid and act pretty much normally. However, yesterday in movement therapy Katinka was out from the start (she’s one of the main fronters). Then for some reason Suzanne popped out and the therapist called for Astrid to come back. Katinka came back with some difficulty and explained that she’s fine being called Astrid but she isn’t Astrid. The therapist insisted that she may be Katinka now but Astrid was out at the beginning. It was quickly time to end the session and we were still pretty spacey but didn’t say so. To be honest we didn’t feel fully safe to go home yet (one of us was having destructive urges), but we didn’t say anything and managed to go home anyway.

Now some of us are thinking of quitting movement therapy or the whole mental health treatment altogether. We’ve run into just a little too many disagreements with our treatment team. I mean, they’re overall good people, not like our former psychologist who just was one giant bitch. We don’t need a fucking DID diagnosis (we’re not fully DID actually). We’re fine calling ourselves pieces or whatever, but we’re not going away. Now we’re pretty sure we’re going to be taken out of movement therapy for it destabilizing us. Well, whatever. If the goal is to keep us acting apparently normally all the time, then we don’t need nor want no fucking mental health treatment for that.