Four Faces

Don’t freak out, this isn’t really the second post in a row. It’s more a continuation of yesterday. Actually, this is what I planned to write yesterday, but I got sidetracked.

I’ve known since I was a kid that there was something wrong with me. I remember feeling the oppressiveness of depression when I was around 3. And while my circumstances were more than enough to make someone depressed, I always knew there was more to it. I was diagnosed with major depression when I was in my teens, picked up a diagnosis of generalized anxiety disorder in my 30s. PTSD I always sorta figured was there, given what I went through, but I didn’t feel there was much to be done about that. Nor did I feel it was particularly much of a problem.

Then I found out about ambient abuse and all my carefully constructed bridges and fences collapsed, sending me into a tailspin (to mix metaphors) – that abuse is the foundation of my other issues. So effectively, all the work I’d done was treating symptoms, not causes, and when I realized that, I couldn’t even treat the symptoms any more. Eventually, a shrink settled on the diagnosis of complex PTSD (why do anything simple?) and that made things both better and worse. Better, because having a name eradicates a lot of stress tied up in the not-knowing. Worse, because suddenly I had to come to terms with myself as a victim. A proper victim, instead of a bystander hit by the shrapnel of whatever’s wrong with my parents. Better, because having a name meant I could research and find others online. Worse, because I haven’t read anyone like me. (The basic problem being that most victims of child abuse also endure physical and sexual abuse, and other horrors. There’s a case to be made that I was physically abused, but I find it debateable. Certainly, it would be marginal and doesn’t line up with the horrors of others.)

Psychological child abuse is difficult to discuss, period. Even if one is very accepting of one’s illness, one tends to self-censor. In these enlightened times, we can own up to depression, anxiety, even PTSD (provided a clear traumatic cause, like a roadside bomb) and generally get understanding from others. Child abuse is also more readily accepted by others; though the shame that goes along with it would prevent the victims from being open. Psychological abuse is something else entirely. How do you explain that your mind is broken, and no one laid a hand on you? That you weren’t in a war, tortured by secret police, or held hostage? That the people who broke you are your parents who, by most measures, were good and caring and provided a stable home? Hell, we have trouble with that, and we know the difference. How can you expect someone else to understand?

Decades ago, once I moved to a city with a decent library, and a university, I started reading abnormal psych. I was also drawn (read “obsessively compelled”) to learning about certain topics: genocide, serial killers, multiple personality disorder, ritual murder, child abuse, and many others. Looking back, I realize that the compulsion was from my unconscious mind trying to tell me that I was a victim. I was researching those topics to better understand my abusers, and then me. Between that, and the abnormal psych, and living alone with too much time on my hands, I did a fair amount of self-analysis. That’s why I was such a high functioning depressive.

It also means that I have a fuckload of academic and medical knowledge floating around in my head. So much that at the first shrink appointment, I warned her not to waste time dumbing things down or needlessly elaborating; that I would ask if I didn’t understand.

It took a few sessions of her starting a simplified explanation and me finishing it academically before she accepted that I really do know that much.

But, as I said yesterday, most of these 10 months have been devoted to backstory, with diversions into current affairs. There hasn’t been a whole lot of fresh understandings.

Sorry, I should have written “hadn’t.”

Because two weeks ago, my shrink made an observation that did shake my foundations.

In session, I had been talking about trying to get my father off my shoulder (figuratively). Every time I start doing work around the house, I can hear him constantly criticizing, (Mom has the other shoulder, for similar purposes) and it drives me nuts. It also makes me not want to do necessary things, like minor repairs, snow clearing, etc. I become bitter and resentful. Currently, I have a number of projects to complete over the summer and I’m sick of hearing dad, so I brought this up as something to work on.

Towards the end, my shrink goes, “OK, I’m going to say something in a minute and, if you don’t know what I mean, ask. If you don’t know what I mean, don’t panic.” (Don’t Panic is always good advice, thanks Douglas.)

She said “Dissociative Identity Disorder.”

I stared at her long enough that she almost started talking again. I beat her to it, however, with a “What? Really? But there’s no alters in here, as far as I can tell. And I don’t have the memory lapses that would indicate them.”

Shrink: “So you are familiar with Dissociative Identity Disorder?”

Me: “I’m not up on the current thinking, but I spent a few years researching, back when it was still called MPD [multiple personality disorder]. I know all about Truddi Chase – though I believe they debunked some of her case – and Sybil and Eve and the impact of false memory syndrome.”

Shrink: “OK. Well, some of the way you describe things line up with DID. Not everything, but some.”

Me: “You think I have alternate personalities?”

Shrink: “Everything’s a spectrum, remember. And I think you should consider that you may be on there.”

When I would get home, it was back into research. Like I told her, it had been years since I did any reading on the subject. When I had been drawn to the subject, it didn’t really resonate. The idea of alters is intriguing, but amateur theatre showed me that I couldn’t even pull off a minimal acting role, never mind having different identities myself. So straight to the DSM-V.

She was right, to an extent. There was many similarities between DID and me. Except for the key indicators: two or more distinct personality states, significant gaps in memory, the presence of those causing problems with work, social life, etc.

However, friends have previously remarked that I see to become someone else under certain circumstances – such as talking to my parents. I always knew/know when that happens, and have shrugged it off. Another trigger for that is being in a situation where I feel expected to talk ‘man talk’ – sports, manual labour, etc. I’m not into sports at all, so blustering my way through that is difficult. But I have done contracting, so I can easily carry on that topic. That is generally accompanied by my hometown accent. And it’s instinctive. I’ve been attributing that tendency to the bullying I endured, and that being a kind of camouflage.

There’s something else: for ages, I’ve described my mental illness as “not me.” There’s me, then there’s the depression/anxiety/PTSD, which taints things and causes different reactions. But that’s the illness, not me. For that matter, I also view my subconscious, creativity, and analytical parts as being not-me. This not-me-but-me things I’ve been interpreting as a handy tool for describing things to other people. I also feel each of my parents just behind either of my shoulders, criticizing, giving unwanted advice, etc. – just like cartoon angels. In that case, I definitely hear them, and whatever they are saying is not memory, but reaction to whatever I am doing. Again, I’ve been dismissive of that – there’s certainly a sound enough basis for my hearing them, and it’s a handy enough method for describing inside my brain to other people. People do tend to hear their parents in their head, or at least it’s common among abuse victims.

The clincher, though, is what I have been calling Mind (personal noun). Mind is a prick. Mind constantly criticizes, calls me down, tells me I don’t know what the hell I’m doing, tries to get me to stop attempting anything, calls me a faker while I’m trying to talk to someone, and on and on and on. Not just anyone’s typical negative voices. Mind aims to hurt and generally does. Mind isn’t me; I could never be that much of an asshole.

It went like this:

Shrink: “For example, you keep referring to Mind.”

Me: “But that’s just communication really. It’s not like Mind is an alternate personality.

Shrink: “What do you know about how DID is treated?”

Me: “Eve- and Sybil-era, the idea was to integrate the alters back into the core identity. With Truddi Chase, the childhood abuse was so horrific that the moment they integrated one of the alters, the memory of the abuse came back and a new alter broke off. So they eventually settled on getting them all to talk to each other, and her core ID.” (I later learned they developed a sort of time-sharing plan for her body, and that that method is the current approach.)

Shrink: “That’s some of the ways. Approaches differ based on the client and therapist. Here’s how I go about it: everyone has a seat at the table. What would that look like to you?”

Me: (puzzled expression)

Shrink: “…Think about a conference table. You are sitting there. So is Depression, Anxiety, your parent’s voices, and so on….”

Me: “Ok…”

Shrink: “So where would Mind sit?”

Me: “He wouldn’t. He’s too much of an asshole; I wouldn’t let him through the door.”

Telling, really. That last sentence came also viscerally. It had enough though not to be automatic, but not enough to have been considered. I spat it out like Mind was a real person. Even though I know he isn’t.

After that session, as I said, I did a lot of reading and thinking. Ultimately, I concluded that, while I might have something like DID, I didn’t actually have DID. Because there are no alters. I have a very strong sense of self (accept no alternatives! [See, I made a funny!]). DID happens when the beginning core identity fractures; new IDs break off, each holding a bit of the abuse. That didn’t happen to me. For one, while what I endured was bad, I don’t see it as being as bad as what people with DID suffered through. But the main reason I don’t have DID is that these other bits are, well, bits. None of them is capable of running things, even for a short time.

Analogy time: ever seen an apple slicer/corer? It’s this blade thing you force down over an apple, and you get this:

See, the apple core is the core identity, the segments are alters. Each is apple, each tastes the same. With DID, any alter can take over to some extent, because each alter is an identity unto itself (usually segmented by age during trauma event). Now, the way I am is more like an apple pealed with a paring knife – chunky bits of peel with some apple on it.  Me, my core identity, is all the white parts left after peeling. Illnesses, Parents, etc., are cast-off bits. Mind is a big bitter rotten part. But those are the bits I’ve thrown away.

My core ID being so solid has sorta caused issues in therapy. Shrink started out with a standard kind of approach: “What does that 6-year-old you need?” She kept trying to address the me-that-was. But that me doesn’t exist. Or rather, he does, but he’s right here. When I look back, I see an infinite number of me’s, stretching back through time and space (I understood multiverse very early), but they are also Me, right here, right now. There is no break. Communicating that to Shrink was difficult. Plus, that’s also the main reason I never saw myself in the DID/MPD category: there is no break.

And when I was reading the DSM-V and other sources, I hit that wall head on. There are no alters, no breakaways, no others. Just me, and broken-off bits.

Then I noticed that Complex PTSD isn’t in the DSM-V. While I was learning why not, I came across the source that exactly explained what is going with me, though indirectly.
Under Symptoms:

“Negative self-concept involves feelings of worthlessness and guilt. While survivors of PTSD may feel “not myself”, a survivor of Complex PTSD may feel no sense of self at all or experience a changed personality; a few may feel as if they are no longer human at all (Lovelace and McGrady, 1980; Timerman, 1981).[1]:385-386. Believing yourself to be “contaminated, guilty, and evil” is commonly reported by survivors of Complex PTSD. A fragmented identity is common, with Dissociative Identity Disorder occurring in some people. [1]:386″  Read more: http://traumadissociation.com/complexptsd

Which is the exact word I’d been searching for. I don’t have separate identities, I have fragments.

Unpacking this is going to require more research, and a lot more thought, and I’m probably going to argue with Shrink a lot, and it’s going to hurt a lot. Some of the fragments I am quite comfortable with. Others, I want gone. Apparently, that’s not an option.

Not so long ago, I described myself as a high-functioning Major Depressive. Then I got GAD, which is a real pain (in the chest, mostly). Then it was PTSD. But not garden variety PTSD, COMPLEX PTSD. Now, to make things even more complicated, I have done DID, but only in fragments. Fukkit, why be simple?

Lyrics to Four Faces by Pete Townshend (for Quadrophenia):

You must’ve heard of them, a kind of screwed-up blend
Split personality
Two sides to fight and argue all night
over coffee or tea

Well, that’s okay, I wouldn’t mind, two say
or even three, and that’s no joke
But with a four-way split, the pocket money’s hit
And all of me is broke

I got four heads inside my mind
Four rooms I’d like to lie in
Four selves I want to find
And I don’t know which one is me

I get four papers in the box each day
Four girls ringing that I’m trying to date
I look in the mirror and see my face
But I don’t know which one is me (I don’t know which one is me)

He kicked me out, He kicked me out
He kicked me out, He kicked me out

I wake up over here and then I’m over here
I’m trying to brush my teeth
It’s little things that are hard
Like starting up the car when I’m still underneath

I get along alright, in fact it’s fun at night
I get four-dimensional dreams
But I have to think before I take a drink
I get hungover times sixteen

There are four records I want to buy
Four highs I’d like to try
Every letter I get I send four replies
And they don’t know which one’s from me

I’ve got four hang-ups I’m trying to beat
Four directions and just two feet
I’ve got a very very secret identity
And I don’t know which one is me

You think it’s funny, I can tell
Well, you don’t understand too well
I get so lonely and turned around
But I can’t let it bring me down

I got four hang-ups I’m trying to beat
Four directions and just two feet
Got a very very secret identity
And I don’t know which one is me

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