Dissociative subtype of PTSD

Anyone deal with dissociation? I just saw something on a Vet. Admin. site..."DSM-5 includes a dissociative subtype of PTSD" Anyone heard of this?
I've tried grounding, and honestly I'm tired of fighting it. Most times I don't even know it's happening until afterwards. And if I'm home, in a safe place what difference does it make if it happens or not, ya know?

I struggle with the similar stuff... it can suck.

I've found basic grounding (like naming things around you, trying to focus on textures or tastes, etc) does little to actually ground me. I had to be good at functioning while dissociated, so I learned to stay checked out through a whole host of stuff. It's not an inability to ground, or a resistance to it (well, ok, maybe a resistance to it, but only because that was useful to me at some point - I needed to act present even if I wasn't)...

I've found doing things that engage my brain helps me ground. Talking about things I'm passionately interested in, talking about my critters, trying to explain how to do something, etc, all help me ground. It kinda sucks, because I always need sometime else there who knows what's going on to get me through the process, but it's the only way I can do it.

As for your question about it not making a difference if you are home and safe, it only really makes a difference in your quality of life. Can you handle being dissociated? If so, and it doesn't make a negative impact on you or those around you, having to ground from it is in your control...

Dissociating is basically a safety measures some people use when faced with trauma (either prolonged, or very severe). It just got stuck in the "on" position for some of us. If you're not feeling safe, it tends to kick back in fairly easily...

my t doesn't focus on grounding as much as she does growing a sense of safety (unless it's the end of session and I need to ground to drive home). She has found that being able to feel safe helps the dissociation more than just simply trying very basic grounding. When I dissociate during session, we explore what's making me feel unsafe, and go back over all the ways I actually am safe in the moment. When I have to leave shortly, she has me talk to her about my pets...

I hope you can find a way to feel safe... do you have a t you are working with on this stuff? Would they be someone you can talk to about different grounding techniques when you need them?

(Sorry if this doesn't make too much sense. It's 3am and I'm not sure how much sense I can make right now)

It does make sense and thank you for understanding. It's 0414 hrs here now I will respond more later when my head is awake and not on pain killers. I can so relate to what you are saying though. Nothing works to ground. I had one bad dissociation event when leaving the T's office (my prior T) it was bad. The next weekly session we both agreed I shouldn't have driven, but she had a client after me so we couldn't discuss it more at that moment. Will talk later not sure I'm making sense now.

I can relate to leaving and realizing after it was a bad idea... these days, we try to leave 10 minutes at the end of session for grounding if it's needed. If even that doesn't work, I just sit in my car until I feel ready to drive safely. I'll listen to music or journal during that time.

Dissociative Subtype of PTSD - PTSD: National Center for PTSD

Yep. This is me. I didn't know this existed. Thank you very much. I was diagnosed with PTSD by one psychiatrist, but he did not explain this to me. He merely said PTSD, which I felt was not accurate because of what I thought he diagnosed me from having told him.

But yes, I dissociate during sex and during crisis. Wow, the light just went on!

Do you ever sleep? I finally got to sleep and just got back up. Anyway...

That event I was talking about at the T's office was one of the deepest dissociations I had been in. That day we had gone over a lot of stuff. When we finished I said "we have gone over a lot of stuff" and then it hit me. The T tried to get me to find all things blue in the room. I don't remember what I found, but I got in my car and drove to Lowes Home Improvement and didn't remember driving there or why I was there. When I went into Lowes I kept looking for Blue things, after walking around in there for a while I finally grounded and went home and went to sleep. I was so mentally exhausted.
Now my dissociation just seems to be short burst, I think. You know sometimes I can feel it coming on a little bit, then sometimes I don't know it happened until I'm coming out of it.
It happens more frequently than I think, I expect. Being here alone it just doesn't matter. I do wish there was an answer to it. I should feel safe in my own home.

You are most welcome. I had never heard of this either. My T has never really explained PTSD to me. This just came up on a feed from the VA.

Also I'm pretty frustrated with the DBT. This last module is dealing with emotions and honestly I feel pretty emotionless. So what the facilitator was talking about really didn't set in with me. I'm hoping that when the mindfulness module roles around it will make something click in my head.
There's got to be something that will help us ground.

Lol about the sleep question. Insomnia is a huge problem for me... last night, I happened to wake up sick and was up most of the night, then I had to go to work later.

Dbt had always been problematic for me. I know it helps a lot of people, but it's quite triggering for me... I'm trying emdr and attachment- based therapy to help. So far, it's going ok. I'm not going to call it a huge success, but I'm doing better with it than other therapies. I hope you can find something that helps you.

Is your t experienced in trauma? If not, is she willing to learn? So far, that's been the most helpful...

I agree sleep is a problem. Just getting to sleep, then physical pain wakes me up. Have tried all kinds of meditation, relaxation techniques to get to sleep. But when it gets quiet and I close my eyes the flashes of memory go into overdrive. Then I fight to sleep/close my eyes. Eventually I get so exhausted that I might sleep most of 24-36 hours. I've heard that PTSD affects REM sleep. My first sleep study , about 12 years ago, I didn't go into REM sleep at all. I was totally exhausted. We are not sure but it may be possible I have narcolepsy also.
EMDR messed me up, but it was because the T had not prepared me for it. So if you get someone that knows what they are doing it may be okay. Let me know how it goes.
I want to give DBT a chance, but right now it's just hard to see how it fits in with what I'm dealing with. If it were just one trauma, one certain type of trauma, but my trauma is all over the place truly complex.
My T works for the VA and specializes in PTSD, not sure about the depth of her work with trauma.

Are you okay?

Doing ok. My T is finally back after a month, and we have a plan for moving ahead with some more emdr in several weeks.

I'm still unsure what the pain was. I got sick for the rest of the day, then it went away the next day... beginning to think I may have ibs :/

Oh wow, sorry about that. Glad your T is back. It's a little scary how much we depend on them.

yeah... I really dislike how much I depend on her...

How are you doing?

I wonder why we get so attached to the T's. I try to keep in mind that going to therapy is a business transaction, no more no less. I don't want to get to a place where I need them.

I've been a little out of sorts since last Friday. Went to the doctor for shoulder pain and she's running all these heart tests, and xrays. At the bottom of the xray report it said "Primary diagnostic code: possible malignancy" So that comment has me a little concerned. I emailed my doctor and didn't hear back from her today. So yes, I'm worried/concerned.

just a bit of info on the original posters question... there is no disorder in the DSM 5 called dissociative subtype ptsd.

whats happening is under the diagnostics for PTSD the diagnosing psychiatrist must .....specifiy.... whether the person has dissociative symptoms and whether those symptoms are depersonalization or derealization symptoms.

example

client ...Amandalouise
diagnosis.....PTSD
please specity....
does this client show dissociative symptoms...yes
are these dissociative symptoms depersonalization yes
are these dissociative symptoms derealization symptoms....yes

now to understand this...... depersonalization and derealization symptoms are opposites, by that I mean depersonalization are feelings about inside one self while derealization is feelings that things outside one self

examples

feeling like I am numb spaced out disconnected, feeling that I am moving too slow, feelings like I am not all there is depersonalization

feeling like the world looks foggy, feeling those around me are moving too slow or too fast, feeling like that plant over there has no connection to me is derealization.

sometimes when people have their PTSD symptoms (anxiety\panic\ nightmares\ flashbacks\sleep problems....) they also feel the depersonalization or derealization symptoms.

as a result of this now the diagnosis of PTSD requires a treatment provider here in america to.....specify....if there are any dissociative problems and if they are depersonalization or derealization.

some locations call this subtyping and other locations here in america do not. my location does not call it subtyping. we call it what the DSM 5 calls it... specifying.

to find out if your own PTSD diagnosis carries the specification of one or the other or both specifiers you will need to contact your treatment providers. they will let you know what your test results and files say on this issue.

ouch, hope it all comes back ok... that's a scary thing to read without having it explained to you... though if it helps at all, I went to one dr for abdominal pain, had tests run, and had a similar note in some of the results. I went to my regular doctor for a follow-up/second opinion. Eventually, after a few more consults, it all came back ok and the notation was revealed to simply be "covering all the bases" kinda thing... hope that's what it turns out to be for you.

funny how the medical community is slowly following sit with webmd, where everything ends in "it might be cancer"... :/ that really ends up ****ing with people in a bad way...

I used to feel like you about therapy, not wanting to need my T. I think it was because I was taught that needing anything at all was a weakness, something that would mean I was broken or defective (even if it wasn't something a fully competant person could dream of tackling on their own, like a broken arm or serious laceration)... Over the past few years though, t has been trying to get me to be ok with asking for help when needed. A crappy side-effect to that is feeling totally helpless around a lot of stuff. It kinda feels like my pendelum was stuck on the side of never needing anyone. T managed to help get that "un-stuck", but in the process of finding equilibrium, I've swung completely to the other side. Some days I can understand it's a learning process; that I will eventually figure out what is ok to expect to do on my own, and what is ok to ask for help with... It's the days that I find myself stuck in helplesshess and hopelessness that mess wth me... Guess it's another conversation I should bring up with T (what's the "expected" learning curve on finding a balance with needs)...

I hope your doctor is able to get back to you today and set your mind at ease.

I'm hoping that the comment was just something to explain all the tests and cover them. Not something they found. Maybe they will respond back today.
Interesting about the pendulum , I too am stuck in the being there for everyone else and not letting others in to help me. I've always been like that though. Have kinda tagged myself as a caretaker and protector. That's why my jobs were so perfect for me. I'm not sure I want to unstick that pendulum.

Good news heard something back from the doctor/nurse by email. "I spoke with Dr. XXXXX about the diagnostic code of possible malignancy. The report only highlights changes consistent with arthritis and she has asked the radiologist to review and make an addendum as this code appears to be applied in error. The report does not indicate any reason for concern."

did some more checking on this.. the reason my location does not call this process of documenting whether a person with PTSD has depersonalization or derealization symptoms by the term subtyping is because that term is a stigmatizing \ stereotyping a person. think of it like saying everyone with PTSD will go out and shoot someone because one or two people with PTSD have in the past harmed others. here in my location we prefer to not stereotype a whole class of people in one package. (where as the term specify just means document whether a persons problems are of a dissociative nature and what that persons individual are...whether they are having depersonalization symptoms or whether they are having derealization symptoms and what are they. individualized according to each persons own symptoms.)

Dissociative Subtype of PTSD - PTSD: National Center for PTSD

For anyone that wants to read it

For me when I start losing keys and wallet and phone while I'm trying to get out the door I know I am dissociating and I literally stop what I am doing and sit on the floor. Today I made a decision not go to a stress management class when I realized that would not be the right thing to do. I also carry a stress ball, coloring book, pens, pencils, dried lavender and rose petals, and scented lotion with me. In DBT they call that a self care kit. Sometimes I bring a stuffed animal too in my bag, or a little plastic toy. I can't afford to dissociate since I'm on bus, bike and walk, although I imagine that driving would be just as dangerous. Also having a routine helps me get through the day, like if I just keep it together until I get home. I've also found knowing I have food at home all ready to eat helps too. And of course there's protein, that's really important for staying grounded.

I travel with some stuff too, usually my pebbles, and a bottle cap for texture. Plus a pencil and paper. I draw and erase a lot.
Last night I must have been out of it. Not sure what I did but I didn't give my cat her meds, I didn't put the trash cans at the street for pick up, I didn't roll up my car windows and lock it. Not sure if I took my night meds. I was shocked this morning when I got up and realized everything that I had left undone.

I hear you, maybe you were exhausted. I use a Pill box to keep track of my morning and evening dose. It's ok.

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Oh I have pillboxes too. Just forgot about them. No biggie, I'm still here.