To Every Clinician with PTSD and DID Clients

This weekend I finally felt the edge of hope for the first time in a long while. Take note, clinicians: it’s not because of medication, a therapeutic approach, or a hospitalization. It seems that the answer all along was incredibly simple: people. I’ve needed to connect with people, in particular, people that understand dissociative identity disorder. Yesterday I met a handful of women with DID, and I’m buoyed beyond words by the experience.

I mentioned my ever constant and present experience of losing time at home, and spending as little time as possible at home because I lose time. I spoke to a woman with the exact same experience. It’s not lost on me that coming out of the isolation with this meant that another person had to have this same experience. I wanted to throw my arms around her as she conveyed her experience to me.

Here’s a note to clinicians that I wish could be delivered to every single one out there: All the talk therapy, theoretical approaches, medications, hospitalizations and case management will do nothing to alleviate the loneliness of mental illness. Group therapy is a regular part of any hospitalization, but once you’re launched back into the real world, group therapy is surprisingly difficult to locate for non-veterans with PTSD or DID. Beyond group therapy, support groups for non-veterans with PTSD or DID are just as difficult to locate as therapy groups. The result is that such individuals find themselves isolated with no peers to connect with. Even the best therapist is no replacement for peer connections. Please do what you can to create therapy groups and support groups for people with PTSD or DID. Many researchers are spinning out trying to find the PTSD cure. Perhaps the answer is not in the cure, but in the connections. Together we can endure a lot if we feel the balm of support. Can the answer be as simple as connections with others? Maybe. This is where we can learn from Alcoholics Anonymous. We all know I’m ambivalent about AA, but they certainly get the people part of contributing to success with continued sobriety. We can’t cure each other of our PTSD or DID, but we can feel less alone in this fight. And some days, that connection may be the very thing we need to get the next day.

The most important thing a clinician can do is seek to create opportunities for peers to connect with each other. Ask your clients if they know anyone else with their mental illness. If you start noticing a trend in that few, if any, of your clients have peer connections start talking with your colleagues. Look for groups. If you come up empty, your clients have likely come up empty as well. Did you know that aftercare from inpatient hospitalization or intensive outpatient treatment always includes a recommendation for group therapy? Most of the time that recommendation is for a Dialectical Behavioral Therapy (DBT) group, which is different from what I’m recommending. But here’s the rub: outpatient DBT groups are also few and far between outside of major metropolitan areas such as Boston or Washington D.C. Let’s work to create communities of support so that no one with PTSD or DID is ever without the connection of another peer. With all the intellect, resources and energy out there this should be a mission that we can make a reality. It’s not an expensive venture, far from it. Tomorrow I’m going to start to be a pain in the ass on this, and I’m going to start asking every mental health professional I come into contact with if we have such groups. I don’t think we do because I’ve done my own looking in my community, but I feel compelled to turn over every rock. Someone needs to ask “Do we have groups for people with PTSD or DID?” “Why not?” “Has anyone ever tried to create such groups?” “Who would know anything about this?”

If I can be a pain in the ass in my own job with my knack for asking annoying investigative questions, surely I can put that skill to use here.

I implore that we all ask our therapists or our colleagues if such resources exist in our areas. Then we need to ask why, and look to rectify the gap. Humans were meant to connect with other humans. Everyone should feel the edge of hope from the understanding of another peer.

To the dude from last summer and the summer before that

We have to stop meeting this way. I am putting a stop to it, against my addictive urges.

We are not going to meet tomorrow night.

I want to see you, but I can’t.

I never told you that I’m a sex and love addict in recovery, and that I have dissociative identity disorder. Previously, I told you that I have PTSD and a severe dissociative disorder. That was my way of downplaying my DID. I know I did this because DID is most definitely unsexy. It’s so not sexy that it’s unsexy.

I rationalized getting intimate with you too soon two summers ago because I liked you. I told myself it was okay because it wasn’t casual sex as casual sex is my bottom line behavior. But then we went our separate ways, and we’ve just had false starts since then.

Out of nowhere I hear from you the same day that I learn of a loss that I’m grappling with. I can’t trust myself to go out with you when I am feeling this way. I have to sit with this loss, feel it, and not try to numb it away by being with you.

I can see myself going to bed with you, and regretting it when I don’t hear from you for another 6 months.

I am no longer interested in playing out this script. I am throwing it away. I truly hope you have a good life.

Be well,

Beatriz

a hard thing

The day before yesterday I learned that Sara, a WordPress blogger, took her own life. I’ve been bereft since then, mainly because I feel I have no right to feel this way. For a period of time, Sara and I corresponded after she posted about her experience at Sheppard Pratt. In that particular posting she ranted in that brilliant and funny way of hers about Dialectical Behavioral Therapy (DBT). I resonated with her rant because I also find it exhausting that too many of these places that treat PTSD and DID put all their eggs in the DBT basket. DBT is not a bad concept, it certainly has its’ good points … but please it is not the be all and end all cure for PTSD. I had completed a stay at Mclean Hosptial’s residential program for traumatic and dissociative disorders, and it was interesting for both of us to hear about each other’s experiences in what many consider the top two psychiatric programs for PTSD in the country. From our correspondence you could see that we both found our programs acceptable, but way too ballyhooed for their own britches.

Sara was much more articulate than I was in ranting about it. I wish I could recall the specifics of what she wrote.

I am most disappointed in myself because I fell out of contact with her. It’s one of those things that happens when life gets in the way.

I will further admit that I became aware that Sara lived less than a 3 hour drive from me. In the back of my mind I planned to tell Sara that I lived close enough to drive to her, and I would ask if she would like to meet. But, it never came to pass. My own life struggles take center stage far too often, and that plan never got off the back burner. Now it will never be.

I sit here stuck now in front of my laptop computer, immobilized from disappointment and undeserved grief.