Recently, I wrote about a book called “Emotional Blackmail” by Susan Forward. At the end of the book, she writes about traps people fall into, that makes us vulnerable when dealing with difficult relationships. One of those traps, is the fear of falling into a “black hole” of loneliness and unhappiness. Forward describes this as a normal reaction that many can have, the fear is often worse than reality, but this fear can be so powerful that people stay in unhealthy relationships or situations. She has a concrete tip on how to handle those insecure feelings. First, she sits there with the patient and ask them to go “into” the black hole in their thoughts. While there, feeling vulnerable and like life never will be okay again, she asks the client to bring forward a good memory. In the book, a woman who is afraid of loosing her husband even if she wants a divorce herself, tells Susan that she feels so alone and afraid that she never will have anyone around her again. Forward then asks her to come up with a positive memory, and to think about what makes her happy in her day to day life. For this patient, a memory of when she was a child and got a horse, comes up. Susan asks her to remember this memory, and the patient immediately feels better and stronger. In this more positive mood, it is easier for her to remember other good things: She has friends, family and pleasurable interests, and she realizes that she can feel afraid and helpless, and still be able to get out of that feeling by thinking about happy memories and what she has today.
When reading that paragraph, I remember a dream I had many years ago. It started as a nightmare. I didn`t know where to go, and felt completely disoriented. I was trying to find my way back after walking in the mountains, but everything looked unfamiliar. I kept on walking, with panic growing inside. Suddenly, I followed a path that lead my to the most beautiful waterfall I`ve ever seen. It was surrounded by a tranquil space that made me cry because it was so wonderful. I felt completely safe and protected, and when I woke, the afterimage of this beautiful place, was still there. I can still feel relaxed and reassured when I think about this place, because it reminds me of beauty in the most difficult of circumstances. Whenever I feel down, I can bring that memory back, and it reminds me that sometimes, you just need to walk for a bit longer, and you will find something that takes your breath away and makes you happy.
So, are you afraid of falling into a black hole you can`t get out of? And do you have happy memories or good things in your life that you can bring forward if you feel alone and helpless?
We all have a house with different rooms. A house filled with memories behind every door. Some rooms contain memories we rather forget, some with past love and some with tools we need to walk into the rooms that scare us. It might be a torch driving away the shadows lurking in a corner. It can be a shovel we can use in the garden to bury what we don`t need anymore. How the house looks, varies. We all have different stories, and need different tools to get where we need to go. In one book about dissociation, they recommended creating a room the with everything you need to be strong. It could be potions filled with strengthening concoctions or impenetrable armor. You could then go into the room, take a mental sip of the potion, put your armor on and be ready for a battle.
What would you put in your house? Which rooms must be locked until you are ready to open them? What do you need when you go in there? Do you need to fill the house with people that can guide you if you get lost? Is there a dog sitting next to you in the couch, ready to defend you whenever you need it? And where is your room of past achievements? Where do you put your medals for getting where you are today, for winning the most important battles of all: Surviving another day.
Like some of you know, I am working on a book version of this blog. After 500 posts I have shared my own reflections and reblogged interesting posts. But, I want the book to entail a number of posts written by others, so if you write about psychology and would like to share those posts, write a comment or an email (email@example.com). Feel free to add a link to the post you are especially proud of. You can share your own struggle With mental illness, or more theoretical posts. You can also share your thought on the Health care system, or on society at large.
I am looking forward to hear from you!
Since I took the dissociation course with Nijenhuis the last year, one message has been firmly learnt. “NEVER think that you know or understand more than the person in front of you”. Trauma-patients are especially vulnerable when it comes to suggestions, and often try to please others by becoming who you want them to be. For this reason, I had to look at myself in the mirror again and again, while remembering that I can`t see or understand what`s behind it more than anyone else. By letting go of my need to understand, to interpret, I`ve understood more (or so I think). By accepting what is, I`ve seen my clients reality more clearly, but I have to keep cleaning the cool surface of the mirror when necessary. What scares me, though, is how easily everyone forgets to do just this. We can walk in dirt until it drowns us, until it pokes us in the face. When the dirt has infected everything, we finally start to clean up. Almost like using a dirty rag to clean up the mess. I´ve heard stories of abuse and neglect, of babies with their diapers so full of shit, that it falls to their knees. That is horrible enough, but I wonder: Is it not worse that grown-ups never change their diapers? Shouldn`t they have learnt that? What kept them from noticing how bad it got?
Our society has a both good and bad sides. The world will probably never reach a perfect balance, but we must still strive for it. How can we heal and preserve? For many therapists, diagnosis helps to find a direction for the right treatment and possibilities. I won`t rant against the system of classification for too long, but I just want to make one point: Who likes to be put in a box? Who likes to be told who they are, from people they barely know? Who likes to get their lives transferred to a DMS-IV classification that lead to life-altering consequences, with the justification of “this is how we do it” attached to it?
I sure don`t. What about you?
A good book! Read it!
Since the story “the Girl in the Window” about Dani Lierow was published in the St. Petersburg Times newspaper on August 1st, 2008 hundreds of thousands of readers across the world have been moved by her story. Readers from around the world continue to read the story of Dani, written by Lane DeGregory, online and hundreds have been inspired to comment. Most of those who have reached out to communicate with Dani and her family have wanted to express their good wishes and support. Many people have requested a way that they can donate funds to support Dani’s long term care and ongoing therapy.
Danielle is doing well; she has grown a lot and is almost as tall as us! She enjoys swimming, horseback riding, and attended “Empower Me Day Camp” over the summer, which kept her busy with lots of crafts, water play, and activities during the summer. We also had two foster girls stay with us over the summer, so there was a lot going on and no boredom at our house over summer break! She started school at the beginning of August, and is doing very well in her special Ed classroom, with a lot less tantrums than last year! She attended several county fairs where brother William showed his goats and chickens in 4-H competitions, and enjoyed the rides, ice cream, cotton candy, as well as looking at all the exhibits
Cathy Rose’s voice doesn’t change while she talks. She doesn’t suddenly bear a different expression or posture. Her Baltimore County accent never leaves her; no Southern belle or gruff motorcyclist emerges. She is, in short, nothing like what you would see on TV or in a movie. But in her mind, Cathy carries the identities of 20 different parts.
The 1994 Towson University graduate has Dissociative Identity Disorder (DID), formerly known as Multiple Personality Disorder. It’s the result of years of sexual abuse by her mother and stepfather. When she was a student, she didn’t know she had DID. All she knew was that she felt nothing—not even the will to live.
“People like to feel like they’re part of the human race,” Cathy says. “That’s how they get joy or pleasure out of life. I didn’t feel any of that.”
Yet for years, Cathy refused to accept her diagnosis. She feared it would make her life much more complicated. She resisted targeted DID therapy until one of several breakdowns left her hospitalized in 2006.
“I realized that until I admitted that I had DID and I addressed my parts, they were going to keep making my life unmanageable.”
Unlocking the Answers
Bethany Brand, a TU professor and clinical psychologist in private practice, has spent more than four years researching dissociative disorders.
Towson University psychology professor Bethany Brand is currently leading the world’s largest and longest study of treatments for dissociative disorders — an umbrella category of mental illnesses, including Dissociative Identity Disorder.
Movies and television have largely misrepresented DID and rarely explained why it exists. The reality is that “parts” are like gatekeepers—compartments that lock away various memories and feelings connected to childhood trauma so the child doesn’t have to feel the psychological damage. For people with DID, mental illness develops when that protection starts to wear down. A dissociative disorder is, by definition, a side effect of abuse—a double-edged sword inflicted on those who should never have suffered the first pains.
“People who have been severely abused in childhood tend to think they are ‘bad’ or ‘weak,'” says Brand. “Several participants in our first study found it downright shocking to fill out our surveys because it made them realize, ‘These are symptoms, not signs that I’m just a bad person.'”
That first worldwide study determined that targeted treatment of dissociative disorders (DD) is effective: patients and their therapists reported fewer signs of the condition, including fewer suicide attempts and psychiatric hospitalizations. For years, researchers from Johns Hopkins insisted these disorders weren’t valid and treatment was actually harmful. The Towson professor and her team had just proven them wrong.
In other words, they sparked hope.
“I think there are therapists who still don’t believe in the diagnosis,” says Rachel Elise ’10, who also has Dissociative Identity Disorder. “It’s one of the few serious mental illnesses that’s entirely curable through psychotherapy, so it’s particularly important to understand how to treat it.”
Brand’s goal is to help an underserved, under-identified, worldwide population
That’s right. It’s curable. Movies don’t tell you that, either, maybe because a cure takes so long. The average psychology treatment study lasts only about 13 weeks. But no one with a dissociative disorder gets better in three months. It takes years.
“People don’t split unless they absolutely cannot handle something, so therapy involves facing that which completely broke you,” explains Rachel, who was severely abused as a child. “It can take a long time to get into a place that is stable and grounded enough to do the core work.”
By current data, the worst manifestations of dissociative disorders affect one percent of the world’s population. The same is true for schizophrenia, a condition belonging to a different psychological category. But when
Brand started researching DD in 2009, there were 103,000 scholarly articles on schizophrenia and only eight on DD. (Her team has since doubled that number.)
RESEARCH ARTICLES, 1995-2013
Depression: 6,750 Schizophrenia: 3,613 . Bipolar Disorder: 1,261 PTSD: 682 Dissociative Identity Disorder: 55
The reason for the disparity is that very few mental health professionals even know how to identify dissociative disorders, let alone how to treat it well. People with DD are often misdiagnosed, leading to years of damaging drug treatments or therapy that never touches the core issue. Worse, some people with DD are dismissed as frauds. Brand’s goal is to change all that, and help an underserved, under-identified, worldwide population get better.
And if improving or saving lives isn’t a strong enough argument, here’s another: the results of Brand’s study could also cut health care costs. Undiagnosed, misdiagnosed or ineffectively treated patients with dissociative disorders deal with repeated emergency room visits, hospitalizations, prescriptions and other care needs.
“Think about the cost savings and reduction in suffering that could come from figuring out how to provide cost-effective interventions,” Brand says.
Brand and her research team are developing web videos for therapists and patients. Used weekly, the videos, along with journaling and behavioral exercises, are designed to help patients diminish their symptoms, regulate their reactions and control unsafe behaviors. Brand’s team includes web designers who will disseminate the videos on servers worldwide—accessible for free. Built-in analytics will assess efficiency, using participant feedback to determine the helpfulness of the exercises.
Funding the Research
Brand’s study, TOP DD (Treatment of Patients with Dissociative Disorders) Network, requires funding—the most challenging part of the process so far. The recession and other cutbacks have made financial support hard to find. Towson University, Sheppard Pratt, therapists, patients and the researchers themselves have contributed.
Art Imitating Life
Rachel is an artist, and she processes her disorder in her work. Unlike a lot of artists, her creations use different media, different styles and different approaches. Those differences, Rachel says, are the products of the parts that create the art.
“That’s why art is so satisfying for me,” she explains. “It’s a way to integrate different pieces of my experience tangibly. Several parts can be saying something different, but it all comes together into one image.”
Rachel points out that “normal” people take certain things for granted, like having a linear sense of time or a consistent way of looking at the world. Patients with Dissociative Identity Disorder don’t have those things. Her art helps explain that. But she says it also conveys a common bond, an understanding that everyone struggles with who they are. “It’s more exaggerated for someone with DID, but I think it’s a universal experience to feel pulled by different sides of oneself, or to question one’s true identity.”
For Brand and her research team, the art lies in finding the most effective ways to help people who have suffered unspeakable trauma as children. It’s work Cathy finds heroic.
“These researchers didn’t have to go into this line of work. To me, those people are crusaders for us.”
By Christine Collins. Photo by Kanji Takeno and DeCarlo Brown. Art by Rachel Elise ’10.
Professor leads groundbreaking search for answers in mental health. Department of Psychology
Rachel Elise’s Art
It’s so hard to stay, and so easy to leave.
A cold sweat hot-headed believer
I threw my hands in the air, said, “Show me something,”
He said, “If you dare, come a little closer.”Round and around and around and around we go
Oh now, tell me now, tell me now, tell me now you know.Not really sure how to feel about it.
Something in the way you move
Makes me feel like I can’t live without you.
It takes me all the way.
I want you to stayIt’s not much of a life you’re living
It’s not just something you take–it’s given
Round and around and around and around we go
Oh now, tell me now, tell me now, tell me now you know.
Not really sure how to feel about it.
Something in the way you move
Makes me feel like I can’t live without you.
It takes me all the way.
I want you to stay.
Funny you’re the broken one but I’m the only one who needed saving
‘Cause when you never see the light it’s hard to know which one of us is caving.