Scattered pieces

Note: This entry may trigger due to issues around suicide being discussed.

I’ve been fairly open about my levels of suicidal ideation on this blog over time. But the last week or so, I’ve been dancing around the subject. The reason why… on the 2nd and 3rd of August I tried to commit suicide.

I’m still trying to make sense of the attempts, and the triggers which precipitated them.

The main things I remember about Monday, are that I didn’t work my usual late shift, and that I was very tired… very, very tired. So tired, that it made perfect sense to come home, empty a pill bottle into my hand and swallow them down with a caffeine drink.

I vividly remember looking at the pile of pills in my hand, and thinking… “This will help me sleep”.

This terminology is significant… “This will help me sleep”. Usually, my suicidal ideation and intent is termed “running away”, so I wonder if the change in phrasing was an indication that different ones were driving the attempt, or whether I was just really tired?

In the past, whenever there has been even a suicidal gesture, a protector has come forward and immediately called for help. But not this time. This time, I climbed into bed and waited for sleep. That was at about 6pm. The next thing I remember, is waking in a panic at 2.45. I wasn’t panicking about the pills that were now well absorbed into my system…  Oh no, I was panicking because I wasn’t sure if it was morning or night, and I was worried about missing work!

The details are fuzzy, but somehow we ended up in ER. ER’s always seem so bright… so well lit… super bright… I know this is a medical necessity, but it’s also about our fears. We hate hospitals. We feel ourselves get smaller, younger and more tongue-tied in hospitals… It’s hard to hear what people are asking of us, and we become more robotic.

As an indication that there was still come cognitive thinking happening, we’d remembered to bring our iPhone with us. Hours of playing Boost 3D, Euchre, Hell’s Kitchen… Anything to try to keep calm! Then the unspeakable happened, the iPhone battery ran out… This tipped the scales back to crazy.

• We removed the lure ourselves and went to the nurses station, asking to leave. They took us through to the observation lounge instead. Yay… power points for recharging the iPhone :)
• WPT came and visited us in the ER, and we brushed him off… told him we were fine and not to worry about us…
• When we were assessed by the psychiatric team… I say “assessed”, but to the system, it felt like a grilling.  They asked about family relationships, abuse history etc.
• By the end of the assessment, angry protectors were up front and they ripped up the discharge papers as we walked away from the nurses station.

Yes, we were released with no follow-up or safety options mentioned.

When we got home, there was still the need to sleep. I think one of us called the crisis team, but gave a fake name… I remember the crisis person yelling at us that they were sending the Police around. This was the wrong threat to make, as it gave the protectors hope that help was on the way. They became less vigilant…

We sat down at the table with enough pills for a fatal overdose. It was very mechanical and quick. Again, there was a need to have enough pills to “get some sleep”. Once these were consumed, we went to bed. Again, a panicked waking a few hours later and a ride in an ambulance.

This time it was serious… I knew that because of the number of nurses around. I remember looking over when they took my blood pressure, and saying how good it was (53/45). Usually my blood pressure goes through the roof in hospitals due to anxiety (the next day it was 195/146). I asked if I could go home, because my blood pressure was so good, and it was all just a silly mistake…

I remember the nurses being nice.
I remember them wheeling me down corridors to a ward.
I remember a nurse sitting in a chair at the end of my bed all night.

We called the mother, asking her to come up because we needed help. Our cat needed food…

We were kept in for a couple of days, and again had a psychiatric assessment, this one was much more gentle. They asked about safety and stressors. They gave us options – they suggested hospitalisation, or respite. But the psychiatric ward was fairly full, and the respite place would be different to the one I’ve been to previously. Instead, we were released to the mother (a former nurse) at home.

The thing that blew me away about the medical ward, was their compassion and understanding. I was there for an overdose, but they didn’t judge. They had almost no knowledge of mental health issues (I had to tell them how to spell “dissociative”), but they were respectful of me as an individual…

It’s now over a week since the attempts, and I’m still on shaky ground. Last night, R was very present. I know it was him, because I could clearly see what he wanted – to be wearing just jeans, standing in the middle of the road, in the pouring rain, arms up, yelling (in pain, release, anger???).

I’m very aware that I’m still walking along the cliff edge. One little push will send me over.

It’s times like this that I realise how amazing the people around me can be… WPT came to see me in hospital (twice); while my blog friends have been a steady, calm voice of reason when I needed it desperately… thank you!

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Now playing: The Freshman – The Verve Pipe
via FoxyTunes

You shall not pass!
You shall not know.
You will never know.
It will destroy you to know.
I will destroy you, before the secrets are told.

This message has been driving my existence for the last week (month?). D. One from my internal Basement has drawn, what can only be described as, battle lines. There’s no give, little communication and no trust. She’s said several times that she hates the rest of us, and has apparently sworn at Allison – not something that I would do.

The problem… We’re getting closer to her secrets, or the secrets in The Basement. This has been deemed as too dangerous for the system by D. One. This is a Polyvore set done last night to prove the point.

What surprises me, is that it looks rather tame in comparison to some of the other works that have involved her (for example D. One). But, it more clearly shows the dissociative wall she is protecting.

As an aside, she was associated with fire and a serpent in the last set, but now it’s birds and trees?

Last week, it became obvious what she will do to protect that wall. It wasn’t pleasant.

As a result, the mother is now staying with us. Those of you familiar with this blog, will know that the mother has a tendency to grate, annoy and trigger different parts of the system. She was psychologically abusive and neglectful during my childhood, and parts felt betrayed and hurt by her. Saying that, there are parts of the system who love, cherish and want to have a relationship with her. At the moment, for our safety, she is being tolerated by us all.

I keep on wondering what all of this activity by D. One means… Reflection is my key to healing and understanding. But yet, I find it almost impossible to reflect on the actions of the past week. I find it difficult to put them into context. If D. One was so stead fast in her rules of no more secrets being shared, why was a young one allowed to talk to Allison on Friday? It doesn’t make sense. Admittedly, there were no secrets shared, it was a very narrow flashback being described, but I’m struggling to make sense of it all.

One good thing about the mother coming up, is that she has again validated some memories, either through mentioning suspicions, or by describing vehicles that were either used, or around during my childhood. I know this is a double edged sword – if she had suspicions, why didn’t she act to protect us? Possibly this goes back to what Paul was discussing when he gave a brief overview of how societies attitude towards CSA has changed over time? Possibly, it’s because we were a white, middle class family? Possibly, it’s because the mother is a nurse who was clinical, rather than emotional and nurturing? All I know, is that it hurts that there were seemingly obvious signs and suspicions, which were ignored. I also know, that this is a similar story for thousands of other survivors.

So where to from here? Well, in just over two weeks, I have an ACC assessment. I’ve been assured by people I trust, that the assessing psychiatrist is good. But, it means describing my dysfunction, past and struggles with someone new. The results of this assessment will determine whether we still will receive ACC funded therapy, or not. We’re expecting to get our funding withdrawn – either because we haven’t shown enough progress, or because ACC will consider us to be better off in the public health system.

This assessment is what is destabilising the system. This is what is ramping up D. One’s activities… The difficult part, is that even once the assessment is over, it could take months for the results to come through. I’m not sure whether the system can cope with that sort of delay.

On a positive note… Two of my favourite blog distractions at the moment are DogHouse Diaries and Message with a bottle. As a warning, the first is a sarcastically funny take on relationships, and the second is a photo diary by a stay at home father of post-it-notes to, and about his son. I add the warning, as I know many of us struggle with fertility issues…

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Now playing: P!nk – Trouble
via FoxyTunes

Please note that this may trigger.

It feels like I’m falling into a black hole…

Over the weekend, the dissociative fog was still hanging over me… everything very detached and unreal… Then, in acts of what I can only consider self-sabotage and self-injury, I sought out ways to break through the fog.  It wasn’t smart, it wasn’t pretty, and if it hadn’t been for a good friend, it probably would have led to some seriously stupid actions on my part.

It started off in the morning by going to the shops and buying some L&P, Salt and Vinegar chips and lollie cake… otherwise known as food triggers from my childhood.  I didn’t consciously buy these things, but they were amongst my groceries when I got home.  This stirred things up internally, but I didn’t really think much of it… the dissociative fog was still keeping everything very separate and numb.

Then, in actions that were so stupid, they’re ridiculous… I read an article about ACC’s mishandling of a clients psychological reports… I watched a 20/20 special on CSA… then one on a religious sect in America… then, to top it off, I read several blogs that talked about either consensual sex, or CSA…

Stupid, totally stupid…  That whole concept of telling others to take care and look after themselves… totally lost on me.

After reading a blog about consensual sex, I lost it…  Flashbacks came through like a freight train…  Sounds filled my head… and the smells… the smells… stomach churning, repulsive smells.

I have no idea which young one it was who carried the memories, but she was hurting so much…  The blind panic, the inability to breathe, the need to run…  The overwhelming confusion, the pain…

Too much… just too much.

What does my head in about the memories, is why didn’t I say anything about what was happening?  Why wasn’t my behaviour picked up as being odd by my teachers or doctors?  Was I that good at hiding it all?  Maybe I was, I don’t know… Maybe being part of a white middle class family meant that those sorts of things weren’t meant to happen to me?

Yesterday I remembered a new piece in the puzzle as to why I didn’t tell…  At the rugby club where the father was manager, they had regular raffles.  Each of those raffles had to be drawn in the presence of the Police.  Each time there was a draw, the father used to take me to the Police Station.  I remember that the Police used to joke with me that if I was bad, they’d have to lock me up.  They showed me the cells.  Put me in them and closed the door, so I’d know what it was like.  I know they did this in jest and teasing.  It wasn’t meant to be abusive.  The always laughed and teased the blonde haired girl tagging along with her father.

This is why I believed the implied threats that I would be locked up if I ever told.  That I wouldn’t be believed.  That I was the bad one in the equation…

We went into see Allison today, hoping to talk about all of this.  But we talked about a safety contract instead.  I know safety is important, but I’m scared… I could feel the resentment and resistance to the idea of a contract and our behaviour being “controlled” through reward and consequences.  I worry about what the backlash against the contract is going to be.  Allison says she’s expecting a reaction… which is fine for her, she won’t be the one experiencing it.

I feel like an open wound…  I feel like this…  If you close your eyes and listen, it takes you places…

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Now playing: Wilhelm Kempff plays Beethoven’s Moonlight Sonata
via FoxyTunes

I’m stuck… Stuck in a hellish limbo.  I’m derealised, dissociated and generally out of touch with reality.  Memories are flicking through my brain, stinging like needles.  I’m so out of touch.

This is the cause…

Stuck in a memory, and can’t get out.  No matter how much I try.  Half the problem is that the memory won’t form so I can work it through.  Just little fragments darting through my mind.

Want to run.  Want to hide.  Want to…?

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Now playing: Natalie Merchant – My skin
via FoxyTunes

The last two days have been kind of rough.

Heading into Thursday, I was feeling good and had managed to pull myself onto some sort of steady ground.  That all fell apart late Thursday afternoon, when I got an email from the other team leader, calling into question the quality of my work.  That email sent me plunging back into self-doubt, self-hatred and all the other associated negative thinking.  My cynical friend told me to forget it; but it was such a back-stabbing insult that I couldn’t brush it off.  To make it worse, my own team leader wasn’t around to reality check the content of the email, and I didn’t want to run to the manager about it.  This spun me out to the point where I knew I wasn’t safe to drive home.  I stayed on at work for a couple of hours, before driving home and losing most of the evening to the dissociation.

Then, on Friday morning during my drive to work, we went past a “hurt” cat in the middle of the road.  I always dread this sort of thing; not only does it stir up the system because an innocent animal has been hurt, but it’s a trigger for some of the younger ones.  Like a deer caught in headlights, we can never look away… we started reciting “it’s just a jumper that fell out of a car”, hoping that this will change how we see the cat… it doesn’t.  This means we now have adult parts smarting from the insult to our work, and young ones upset that an innocent cat has been hurt.

So we’re now driving down the road reciting out loud “it’s just hurt, it’s ok, it’ll get up soon and the people who love it will come get it and take care of it”.  There was also a promise that we wouldn’t drive home that way, just in case it hadn’t been moved.

Work on Friday is mostly a blank… I know we had a morning tea for the two new people, and that the manager made a triple layer banana and pineapple cake (which did a rather spectacular topple over during the cutting process).  I also know I played around with the iPhone app kooaba, as we’re looking at new ways to try to deliver information through technology such as QR codes and visual recognition apps.  This was fun because we were going around the library, taking random photos of books, CDs and DVDs to see what information kooaba would return.

Then it came to the drive home… all the way up the street where we should have turned off to avoid going by the stretch of road where the cat had been hurt, we were consciously thinking of turning.  Then there was this little mind fit, and we were suddenly past the turn off.  I could hear the panic, but there was also this firm voice telling me to stop being so silly, that there will be nothing there, and it will all be fine.

Thankfully the cat was no longer there, but that didn’t matter, the panic had set in.  We were switching all over the place and I could feel our throat closing up.  Little Michelle came forward full force, meaning that we couldn’t really drive, talk and only barely functioned enough to get home in one piece.  Because we live in a high fenced section, no one saw us getting out of the car shaking like a leaf and stuttering about it hurting.

We got inside, fed Winnie, turned on all the lights, curled up in the corner of the lounge and tried to ease the shaking.  I had no real sense of what was happening, but there were obviously body memories.  The throat was closed off, and no matter how hard I tried, I could barely stutter.  I managed to take some anxiety medication and send the following email to Allison…

turn all the lights on an hide
turn all the lights on an hide
turn all the lights on an hide
turn all the lights on an hide
turn all the lights on an hide
turn all the lights on an hide
turn all the lights on an hide

hide got to hide
he’ll find us

I think we finally went to bed at about 8am (it was naturally light by then) and slept for a couple of hours.

Saturday had been good… we’d talked to a friend and took some pictures of the stuffed toy we got for the young ones as their reward for going through the divorce proceedings…

This made me think that tonight was going to be easier… the fear seemed to have eased.  But it’s now 1am Sunday and all the lights are on again.  Little Michelle is ok as long as all the lights are on.  We’re also ok as long as we don’t even think about going to bed.

One of the big problems with this scenario, is that it opens us up to further dissociation and self injury.  We’re so switchy and shaky…

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Now playing: Missy Higgins – Where I Stood
via FoxyTunes

Today, I saw the crisis team psychiatrist… it didn’t go well.

He showed me to the interview room, with this pleasant, eager young woman following in his wake.  I was a little puzzled about her presence, but had a sneaking suspicion that she was a training psychiatrist come to sit in on the interview.  Having had this before, I knew that they always asked if it was acceptable for the trainee to sit in, at which point I was ready to politely decline her being there.

We entered the room, and he sat down briefly, flipped through my file, noticing that there weren’t any blank pages, so left to get some.  Saying over his shoulder to the eager young woman (who had scooted her chair up to the desk), to introduce herself.  She was incredibly polite, saying that she was a trainee nurse.  When the psychiatrist returned, I asked if she was studying at the same institution where I worked – she nodded eagerly.  I asked that she not be present as I worked there and didn’t want to discuss the issues I was facing in front of a student from the same institution.  His immediate reaction… “But, she’s here for my safety”.

Apparently I look like someone who would either physically attack this old man, or scream sexual harassment.

What was interesting, was that at no point did he consider my safety.

His compromise, was to sit the student in the corridor just outside of the office with the door wide open.  It was a busy corridor.  At one point a woman stood at the doorway for over a minute trying to close an adjoining door – while loudly talking about her inability to do so.

Then there was the interview…

“So you didn’t show up for an appointment last week with Dr X”
“No, I’ve shown up for every appointment that has been made for me”
“Accusation number 2″
“No, I took care of myself”
“Accusation number 3″
“No, that didn’t happen”

So it went on… “What’s your mood level?” “How are you sleeping?” “What drugs are you taking?” “How much and how many have you got left?” “What do you want?” “Why are you here?”

Then it got worse. “I’ll prescribe X drug”. I asked what that was… he went into a long description about how benzos are addictive and their effect diminishes over time. He didn’t actually tell me what the new drug was, just how bad my current medication is. When I asked what the new drug would do, he said it would calm me down. I asked about another drug that I’d been recommended, and he scoffed. Saying that’s an anti-psychotic and that I’m depressed; and they only give that drug as injections up at the hospital anyway.

As I’d checked about the use of the drug before going into the appointment, I knew that it was also used for PTSD symptoms – my main problem at the moment; so I knew he was wrong about it’s use.  But I didn’t correct him… he was not a person to be corrected.

We’d started the interview pretty low, but this crushed us.  We crumpled.  I asked if it was ok to leave, he said yes; so we got up, thanked him for his time and left.  As we were doing so, he flipped my file shut with a sigh and leaned back on his chair.

I know I didn’t handle the situation well… I know I should’ve taken the drugs he was offering… but I couldn’t cope.

When I got back to work, I put my things down and told my cynical friend that I thought I was going to cry… we went into a spare meeting room and it all came out.  How I dissociate, how unsafe I am, everything…  She contacted the work place therapist who sat with me for an hour talking about things.  When I described the appointment to him, his comment was… “Yes, the psychiatrist had done his job.  He’d mentioned all the right things in all the right ways; but he didn’t care what happened beyond his vision of what you were and needed”.

It was this therapist who gave me the two creative expressions that I put up here today.  I decided to remove one, as although parts of it were powerful, the potential for triggering someone outweighed those benefits.

I’m still at a loss as to what I can do.  The birthday has now past, and that seems to have eased things internally.  I’m back at work, and that has forced a level of functioning.  I also have my cat back home… that always makes life good.

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Now playing: Sarah McLachlan – I Will Remember You [Live]
via FoxyTunes

Yesterday during lunch at work, I had no idea who I was.  I had no idea what my name was, how old I was or where in the world I was.  There was a sense of detached wonder about being able to use the computer… “wow, I can use this thing”.  I had no memory of learning how to type, or even how to use my body to do basic things such as pick up my cup.   Everything seemed so big, scary, and yet wondrous at the same time.  It also seemed really bright… the artificial light in the office felt like I was looking directly into the Sun.

This is yet another sign that the dissociation is out of control… this was a young one from our internal Basement, in charge of the body, while at work.  That can’t happen again.  It’s not fair to the young one, or to the ones who usually attend work.

The problem is, what to do in order to get some sense of control back?  We’re actively doing all the coping mechanisms we can think of – breathing, taking breaks at work, distracting, grounding etc.  But I’m still a mess.  I’m constantly getting flashbacks of some sort… I’m seeing things out of the corner of my eye (psychosis or a lack of sleep?)…  It feels as if I’m constantly on the edge of switching – that spacey, free-falling feeling…

There’s also dread… I don’t WANT to know why I keep on seeing flashbacks of the changing rooms at the rugby club; I don’t WANT to know why L&P is suddenly a trigger; and I don’t WANT to know why I keep hearing certain phrases over and over in my head…  I’ve had enough…  Surely there can’t be more.

But, I also know that I need to listen and try to understand what’s happening internally. I know this is the way to healing… listening, understanding and easing the pain.  But, I don’t think I have the strength to do this anymore…

Below is a something that was created while at work earlier in the week.  I’m not good at art – I got a D for it in school.  So I’m unable to translate what is in my head into something that is recognisable in practice.  I keep trying to tell myself that art within a healing context is more about the feelings, than the technique… but I still can’t get past how bad it looks in comparison to what was wanted.  It’s so frustrating when I can’t find a way to express what is going on in my head…

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Now playing: Cat Stevens – Moonshadow
via FoxyTunes

It always starts out small… or seemingly so.  That one last trigger that pushes you over the edge… some threat to safety… the hint of a flashback… a confrontation at work…

Then…

The heart starts to race… you feel it pounding and hear the blood rushing in your head.  Breathing feels impossible… like you’re breathing through a straw… but, it doesn’t matter anyway, because you don’t have any lungs… your breath goes no where, it’s just an activity for your mouth to do out of habit. You put your hand on your stomach to try and force yourself to actively breathe deeply… but your stomach muscles move purely on reflex.

Fuzziness hits… lips tingle… then the rest of your face.  Palms sweaty and no longer associated with your body.  Legs disconnected and unable to move.

And the noise…

Screaming internally… strong voices trying to cut through the chatter.  All to no avail.  It’s lost in the torrent of chatter and screaming.

You feel the dissociation pull… but it doesn’t happen soon enough.  A door has opened into the hell inside your head and there’s no going back.  No longer adult… now a seething mass of voices screaming out in pain.

Just stop the heart… don’t slow it down, stop it.  Anything for relief…

The tightness travels across your chest into your arms… the clinical side of you wonders if this is a heart attack.

Head swimming and mushy now… the screaming echoing around.

But always, hypervigilant of what’s going on around you… you back slowly to a wall… scanning the room for any threat.  Trying to contain the crazy and appear normal… please don’t let anyone notice…

Noise jars you into a startle response…

Your movements become stilted… every muscle aches from tension.  Your body is ready to sprint for safety, but it doesn’t know which way to go.

Time warps… seeming to slow down, yet race at the same time… it feels as if this moment will never end.

Then, mercifully… you feel the Earth tilt… yes… blissful oblivion.

Blackness of dissociation… feeling the rush of the protectors coming forward… slowly the noise fades away.

Sleep… blissful sleep.  Only to wake an hour later as if coming out of a cotton wool cocoon… your voice is a little louder than usual.  But that’s understandable, because you feel as if you’re looking out at the world from about 5 paces behind your eyes.

The noise from the outside world echoes around in your head…

Nothing seems real.  Derealisation settles in… your hands belong to someone else, colours seem brighter and everything is disjointed.

Drugs… too late for the panic attack, but it might help with the derealisation.  A fear that the protectors took some during the dissociation… you start to second guess yourself.  But you can’t go on like this, so risk the drugs anyway.

Covert looks around… no one sees you popping the pills.  Just breathe…

Finally you feel that rush of air go into your lungs… the big ball of tightness at the top of your chest slowly eases…

Slowly, the automatic actions ease and control returns.

But there’s still that nagging fear… it will be worse next time… someone will see next time… you can’t do that again…

Internally the chaos is stamped back down… layers of dissociation bury the screaming… different ones are returned to their cells… locked away and ignored…

Until next time…

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Now playing: Natalie Merchant – My Skin
via FoxyTunes

In New Zealand, in order to receive ACC assistance, you need to have a diagnosed mental illness directly related to the abusive injury. I know from reading other blogs, that health insurers around the world, often require a recognised diagnosis in order to provide (or exclude) coverage. Depending on where you’re from, that diagnosis is determined by either the DSM (Diagnostic and Statistical Manual) or the ICD (International Statistical Classification of Diseases and Related Health Problems). In New Zealand, we use the DSM, and this is currently being substantially revised – some say rewritten, and is due for release in 2013.  If you’re wondering why I’m worried about something that is so far away, well, this manual determines whether I will receive ongoing assistance, what that assistance will look like, I enjoy being an informed consumer, and I’m curious how mental health professionals perceive my various reactions to life.

At the moment, the proposed revisions have been made available at DSM-5: The Future of Psychiatric Diagnosis.  There had been all sorts of rumours circulating that there would be a whole plethora of new diagnoses, and the removal of others – including DID.  Based on my rather uneducated eye, the changes are “interesting” rather than sweeping.  Running through the disorders that I’ve been labelled with over the years, there’s an interesting mix of tightening of the definitions, and what seems a desire to create a “catch-all” diagnosis.  Here’s my take on a couple of them…

300.14 Dissociative Identity Disorder
My first concern is that they are now going to allow the disruption of identity states to be reported by the patient.  Call me cynical and a worry wort, but if you’ve read tales of caution about the “attractiveness” of having DID (for example Tempy’s entry Lemme just say it), then this may open the way for some misguided people who have problems, but not necessarily DID, to “seek” the diagnosis.

Then we get onto the “experience of possession”… I think they need to clarify this wording somewhat.  To me, it sounds like something associated with spiritual or religious possession.  That again, could just be my cynical take on it.  This could be saved by the wording of the last criteria, where the disturbance is not part of “accepted cultural or religious practice”.  But still, the word “possession” conjures a certain image that isn’t positive!

There now seems to be some acknowledgement that abusive events can be repressed – “Inability to recall important personal information, for everyday events or traumatic events, that is inconsistent with ordinary forgetfulness.” I know this won’t eliminate the False Memory Syndrome (FMS doesn’t appear in the DSM as far as I can tell) supporters, but it gives an official nod to the research supported indications that traumatic events can be suppressed, or forgotten as part of a coping mechanism (and the crowd goes wild – insert by Mickie).

According to the rationale behind the changes, this new wording is aimed at reducing the use of DDNOS, the understanding that forgetting everyday events is common (i.e. mild dissociation is common) and an indication that conversion and somatic conditions need to be looked at when making any diagnosis.  Personally, I think the wording could benefit from some further work.  I rather like having DDNOS as a “fall-back” diagnosis when I’m faced with a mental health professional who doesn’t believe in DID.  But overall, I can see some benefits to the changes – the big one for me is the inclusion of the inability to recall traumatic events.

309.81 Post Traumatic Stress Disorder
There seems to be further indication that dissociation is a normal response to trauma – something that the research has shown for years, with the wording “Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.)”

Persistent distorted blame of self or others about the cause or consequences of the traumatic event(s)” – they’ve acknowledged that self-blame is an issue for survivors!

Irritable, angry, or aggressive behavior” – added aggressive behaviour, which is a great inclusion – I’m thinking in particular about my ex-husband with this one.

According to the rationale behind the changes, there appears to have been a great deal of input into this diagnosis, but little actually changed.  The changes that have been made appear positive in broadening the scope of the reactions that those with PTSD can have, as well as defining the time frame associated with the onset and continuation of symptoms.  I admit not to having as much of a vested interest in this diagnosis, as I think pretty much any survivor will fit this diagnosis.  It’s more about how far reaching it goes.  I appreciate that they’ve indicated the dissociative experiences that can occur – but it begs the question as to why DID is not on the PTSD spectrum?

301.83 Borderline Personality Disorder
I’ve heard of BPD being a diagnosis given when they don’t know what else to label you…  Overall, I think that those with the diagnosis have an incredibly bad reputation which is undeserved.  I’ve been labelled as having “Borderline traits”, but when reviewing the PTSD criteria, the behaviours that they describe as “borderline” could be PTSD.  In many ways, the revisions still allow BPD to be a “catch all” diagnosis for when they’re not sure what else to do with you.  It has aspects of PTSD, dissociation, psychosis, low self-esteem, impulsivity, etc.  When you look at the different aspects on the surface, it is easy to see how many survivors could meet the criteria; it’s only when you do the diagnostic tests that you realise that the severity needed to meet the diagnostic criteria.

To me, this diagnosis seems to have been fleshed out substantially.  This worries me when you consider the poor reputation and often poor treatment that those with BPD receive…  When I was initially given a diagnosis of DID, I was told there were no treatment plans for that diagnosis in New Zealand, so they sent me through the system with a diagnosis of BPD… I was shocked, dismayed and victimised by some of the mental health professionals who treated me as “another borderline”.  It’s taken many years for the public health system to remove BPD from my records.  I can see with this revision, that many more people may receive the diagnosis and associated poor treatment.  Mental health professionals really need to change their attitude to those with BPD.

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Overall, the revisions seem intent on minimising the use of the “NOS” diagnosis.  But in some areas it won’t be possible – from my understanding of the criteria, I will still meet the EDNOS diagnosis.  I’d encourage you to check out the proposed changes… it’s an interesting process they are undertaking.  There has been criticism that the work is being rushed, so that means we have more of an obligation to check it out – especially mental health professionals!

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Now playing: Sarah McLachlan – Angel
via FoxyTunes

A couple of weeks ago, when we were heading into the anniversary surrounding the last attack by the now ex-husband; Liz asked me if I missed him, and if I wanted him back in my life.  As an adult, I immediately said “No, I don’t want anything more to do with him”.  If you look at it from a dispassionate, adult point of view, it makes total sense to want nothing to do with him – he was sexually, physically and psychologically abusive.  It’s not a good thing to be abused, so therefore it’s not good to be in that relationship as it existed.  This makes intellectual, and common sense!

Today, I realised the answer isn’t that simple.  The dynamics surrounding being a battered partner come into play – he didn’t hurt me THAT badly… it was only when I did something wrong… it was really all my own fault… other people said we picked on him…  Suddenly the waters start to get muddied.  Parts of me excused, allowed and encouraged his abuse.  There was a comfort in the pain he inflicted, it was familiar to us and therefore gave a sense of certainty about what to expect.  He was also very good at inflicting pain… he knew the right insult to throw, when to be nice, when to inflict the worst of the sexual abuse.  In this respect, the relationship was a perfect storm.

He was immature in many ways, and that immaturity showed through in ways that were unexpected.  He could be incredibly gentle with the very young ones.  He could also make us laugh -  I really miss laughing with someone.  So it wasn’t all bad…  This all adds to the feeling that the relationship is being blown out of proportion…

But today, I realised what I really miss, is his violence.  He was a dangerous man – over six foot tall, solid build and trained as a security guard.  His violent rages could be spectacular – holes were punched in doors, walls and objects.  His level of sexual perversion meant that I was often re-creating abuse from the past.  But most importantly, he tried to kill me!  He put his hands around my neck and squeezed until I couldn’t breathe.  He had a power over our life that some of us miss.  We’ve failed at committing suicide several times, but he came close to killing us… he could take that suicidal failure out of our control…  He could kill us… This is what some of us are missing – the ability to have the choice about whether we are alive or dead taken out of our hands.  This is also what we were looking for with some of our self-injury… that dangerous situation where things will get out of control, and we’ll be killed.

We’ve constantly struggled with suicidal ideation, but I never realised the depth of the feelings.  We don’t want the ex-husband back to work on a happy marriage, we want him back to kill us.

This makes me wonder how often we goaded him on… how often we started the arguments… how often we poked at him, knowing it would cause a reaction…  Even after the last attack, I’m aware that Frank came forward to goad the ex-husband – “Come on, come on, pick on someone your own size”.  Frank was slapping at the ex-husband while saying this… I’m not sure if he was defending us, or trying to continue the fight.

I’m not sure where I go with this realisation.  I consider it serious and have contacted Liz to let her know what is happening.  But really, what the heck do I do with this?  Is my wish for death so great that I will try everything possible to ensure I succeed?  Do I wish for a miserable existence, with an abusive man?  If this is the case, I know there are many men who would be willing to abuse me…

Sometimes I shake my head with the realisation of how screwed up I am…