Reality Testing

Reality testing is a new diagnostic criteria for dissociative disorders. short version here in america the mental health field now has a way to distinguish whether the problem is because of a psychotic symptom\disorder or a dissociative disorder. many people with mental illness have more than one mental disorder where sometimes their symptoms over lap\cause problems that may resemble other mental disorder problems.

example I have dissociative problems as well as depressive\bipolar problems. sometimes its hard to tell whether a problem is because of one or another of my mental disorders.

now there is a way. its called Reality Testing. with dissociative disorders reality testing remains intact. what does this mean....

reality testing is....

knowing what is real and what isnt no matter which mind set a person is in..

example
as amandalouise i know I am a real person, i know that the computer I am typing on is real. I know I have a body, i know that is my hand, i know that is my face in the mirror, I know when I am dissociating (feeling numb, feeling spaced out, feeling disconnected,) I know I am not hallucinating, i know what is my problems vs my neighbors or someone elses online, staying real to me with out taking on other peoples symptoms (taking on other persons or what is read about is a psychotic disorder called fictitious disorder imposed on self) ... I know what I am going through is real or not and can compare my thoughts and actions to reality and know whether something is real or not by asking my self questions like do windows really talk, no so when it does its a psychotic problem not a dissociative problem.

As Rainy I know what is real and what isnt, I know when I am reacting \remembering a memory, I know I have a physical body that I reside with in (I may feel the body is mine or that I share it with others depending upon how much co consciousness there is) I know when I am imagining \ daydreaming, I know what i can and cant do, I know what my job, purpose reason for being created is, what I do for the one I reside with in .. all those sense of agency issues.

As Red I know what is real and what isnt, I know when i am reacting \remembering a memory, I know I have a physical body that I reside with in. As red I know what I am feeling vs what is real. I know what I can and cant do, what my sense of agency is, where I fit in. know what is in my mind vs reality.

one good way I have used to discover whether something is my dissociative problems vs my psychosis problems associated with my other mental and physical health problems is by remembering psychotic means reality testing is not intact and dissociative means reality testing is intact then asking my self questions...

in reality can that happen... can I tell what is real and what isnt, ....can i tell whether I am thinking\remembering \ doing something in my mind vs what i am actually doing.

if the answer is no to any of these questions I can be assured that this is not a dissociative problems due to my reality testing has shown i am out of touch with whats real and what isnt. thats when I contact my treatment providers and say hey I think my meds are needing some help\ changing I cant tell whats real and what isnt so i know I am having a delusional thought or hallucination \\psychotic reactions.

if the answer to the above questions is yes I know the solution ....for me... is to use my grounding, breathing , row my canoe around the lake and other therapeutic ways I use to get myself settled back out of my dissociative symptoms.

i guess i am not understanding that because my sense of reality when there is dissociation can almost completely disappear. and when you look at derealization and depersonalization, they are where a person feels like they are not real, their thoughts aren't real, or their surroundings are not real and variations like that. so, knowing what is real in those cases becomes difficult as a result of dissociation.

what happens with me at some times where dissociation is involved is like a dissociated part mixed with i guess an emotional type of flashback or state, but the combination of it can sometimes cause an extreme reaction including paranoia where there is the fear something very bad will happen (beyond a panic attack type of fear). so, it's like layers of things mixed but still related to severe dissociation which also causes the sense of reality to be confused, unreal, like a waking nightmare, etc. where my head is foggy, memory of it is fuzzy/disappears after it lessens, etc. so it's hard for me to sort out what is what..i just know things feel very scary and parts of me get stuck in it including me.

at times, it has caused hallucinations as well...but it's all a result of dissociation and the reactions and combinations of things. i have no diagnosis of psychosis or anything like that. i have discussed it with my psychiatrist, and she has recognized it is all a result of trauma reactions and related dissociative experiences. i don't have a diagnosis of PTSD either, just borderline personality disorder (but that doesn't include any of this), DID, and OCD.

yes I agree it can get confusing and hard to figure it out.

suggestion of something I use when i have my depersonalization\derealization...

the reality testing technique of feeling vs believing...

when a person.....feels ... its dissociation, if you can use the phrase "I feel like im not real, I feel like the world feels not real, I feel like my thoughts are not real, I feel like that ball over there is not real...."

when someone ...believes... its psychosis...I am not real (obviously Im am real because I have a physical body and would not be posting if I wasnt real) that ball over there is not real (obviously it is real because I can go over and touch it, ) my thoughts are not real (obvious reality testing in this is if thoughts were not real I would not be thinking them)

examples

I .....feel .....like I am not real is dissociation.
I ...believe.... I am not real is psychosis.

I disagree with these 'absolutes'. I think there are many grey areas with dissociation, and there are times when what an alter feels is what the alter 'believes' - even though it doesn't match with the external reality - but it is definitely not because of psychosis. There have been many, many times when alters in this system have not been aligned with the external reality, and a 'diagnosis of psychosis' would have simply been plain wrong.

Current experts in the field are well aware of the overlap of dissociative experiences and symptoms of psychosis, with at least one study showing that people with DID can experience MORE first rank schneiderian symptoms than actual patients with schizophrenia!

For those that don't know:
Schnei·der first rank symp·toms
(schnī'dĕr),
those symptoms that, when present, indicate that the diagnosis of schizophrenia is likely, provided that organic or toxic etiology is ruled out: delusion of control, thought broadcasting, thought withdrawal, thought insertion, hearing one's thoughts spoken aloud, auditory hallucinations that comment on one's behavior, and auditory hallucinations in which two voices carry on a conversation.


I would be much more careful in suggesting that something so simple as an alter 'believing' something rather than 'feeling' it is evidence of psychosis.

There are many aspects of dissociative identity disorder that fly in the face of 'reality testing', that do not and should not warrant a diagnosis of psychosis.

Examples:

A child alter in an adult body
A male alter in a female body
A female alter in a male body
An animal alter in ....
An age-slider alter
An introject alter
An alter who is 'stuck' in a previous traumatic event
An alter who denies being the original person (ie: pretty much every alter that exists!)
etc etc etc

All of these are examples of believing something that is not aligned with actual reality, in the context of DID. And what about these scenarios:

Alters having conversations within ones mind (co-consciousness)
Alters deleting thoughts, adding thoughts, or otherwise manipulating the experience of the presenting alter
Alters creating an internal safe place

Do these things exist in the external reality? No. Is that then evidence of psychosis? No. No it is not.

The reality testing of every single person with DID is impaired. But that does not equal psychosis. (It doesn't rule it out as a dual diagnosis either, but that is a different story).

if I remember right your location may be the UK. your location may go according to other psychological definitions than the USA.

my post was based on my location, my having dissociative disorders and what the American Psychological Association defines the term reality testing remains intact in the diagnostic criteria for dissociative disorders here in america.

you can find contact information for the APA (American Psychiatric Association) on their website. they welcome questions and feedback on the DSM5, present diagnostics and mental disorders.

you can also go to your local library and read the actual diagnostics for dissociative disorders. each disorder is listed in the DSM 5 with a format of first detailing the diagnostics then 5 subsequent pages after each disorder that goes more into detail on the disorder, diagnostics and other important information like culture, statistics and more.

your own treatment providers can also explain in more detail what the words reality testing remains intact means in relation to dissociative disorder.

you can also google the words.. Reality testing psychological definition and you will get many results detailing how the term came to be and what it means today in different locations, and with different mental disorders.

a bit of information on the term reality testing....

the first person that used this phrase was Sigmund freud. he used the term and developed questions that would distinguish the difference between what is reality and what is psychosis. what is outside ones body vs what is in ones mind.

the phrase reality testing wasnt meant to nor is it supposed to define a persons emotions, memories, feelings, whether someone has alters or not...

its simply a phrase to help people to know what is outside their minds and what is inside their minds.

even normal people hold onto beliefs, that doesnt make them psychotic.

psychosis is believing in things that can not possibly be real.. if I believed I could fly like a bird in psychology terms that would be a psychotic belief.

Again ....Im not saying alters can not believe in things....

Im just saying this is the ......psychological definition..... of what reality testing is ....here in america.... and how it fits in with the diagnostics of dissociative disorders, per APA standards, by using my own situations for examples.

yes very interesting points for thought. since I didnt have alters of opposite genders, or age sliders I never asked how reality testing fit in with those issues. your own treatment provider can tell you how reality testing fits in with these kinds of alters. but from reading posts here of others that have these problems...they state right in the posts they know they reside with in a body that is not how they perceive their self. so my guess is that reality testing does remain intact.

I did have an introject but because introjects in the USA are not considered dissociative type alters they are considered to be a type of alter any body mental disordered or not can have so again I never looked into how and whether reality testing remains intact with that kind of alter. your own treatment provider can tell you how this issue fits in with this.

I did have animalistic alters but reality testing remained intact. they knew they were residing with in a human body and not everyone claws, bites, screaches, they knew what was real and what wasnt.

alters stuck in time or a particular event my own treatment provider explained to me that reality testing was still intact. reason being those trauma's were real, that time frame did happen so it was real. it would not be reality if for example the alter was ....imagining.... they were being hurt in a way that they have never been hurt (hallucinating or delusional) or if july 10 1970 was not a real date or time frame.

an alter denying they are the body born... thats reality intact because each alter has their own identity. basically what DID is ...having alternate personalities that are not the body born. DID exists therefore reality remains intact. there was once a time in america where it was believed there was no such thing as a mental disorder DID but now it is recognized as existing/ that it is real.

your treatment provider can answer more in detail about what the diagnostic reality testing remains intact means.

I want to add in an apology to you, AlwaysChanging, as I used transgendered alters as an example of poor reality testing, when it is actually becoming clearer and clearer through research that transgenderism (as a stand alone and not specifically related to DID) is a very real and natural way of being caused by genetic and biological factors. (And, of course, can exist with and alongside DID to complicate matters even further!)
Sorry - I just wanted to clarify to avoid you possibly feeling invalidated by me using transgendered alters as examples of 'impaired reality testing'

think that's a good thing to do

i did the same thing recently in the anxiety forum

apologised tro someone for making it sound like they sounded like 1 of my alters, but what i meant was the message above (which was posted by the shattered sanity account) looked like it was posted by 1 of the younger alters.

i'm also impressed with your knolledge and insight on this subject.

thanks for sharing

AmandaLouise, I love that in your particular part of the world the treatment providers know everything, AND they know exactly the same stuff. Unfortunately it is not that way in the other areas of the USA. While the diagnostic criteria for dissociative disorders are clear in the DSM-V there are a great many treatment providers in the USA who do not believe in them and have understandings that differ greatly from yours. When it comes to dissociative disorders I bet my current T wouldn't have an effing clue. It would be interesting to ask her actually, just to see what she would say on the topic. It is possible she would allude to DID being extremely rare (it is not) and most often caused by bad therapy (it is not). In that case would the advice be to believe what my treatment provider tells me? I would hope not!

I never, ever acquiesce to any provider of any sort as being a fount of knowledge, and especially so when it comes to my own physical or mental health. I am intelligent enough and curious enough to source my own information, deduce its credibility and come to my own understandings as to how that information relates to me. There is no treatment provider in the world who could tell me what my experiences mean for me.

So, back to the topic of reality testing here... we will have to agree to disagree.

yes that is what you and I end up having to do when it comes to all my posts / threads, sometimes it is best to "agree to disagree" in order to keep a thread on topic. thanks for the reminder and helping me to get this thread back on topic.

my location and the purpose of this thread is to go according to the actual American Psychiatric Associations definition (which is what my location goes by) for what reality testing is.

it is ok if other locations go by a different definition. but I would love to keep this thread on track of what its meant to be..... help to understand what the dissociative diagnostics are for those that..... do......... go by the same diagnostics and standards that my location does.

for those that go by a different definition/diagnostics standard you will need to contact your own treatment providers who can tell you what reality testing is in your own locations and how it pertains directly to your own problems.

Thats okay, I'm fine with it.

By definition, this all applies to me.

With DP/DR, my best example which is true because it happens a lot, I can be sitting on my bed in my room to then suddenly feel like I'm enveloped in a bubble as it settles on me, much like going under water. Everything around me, stuff, the walls, the bed, even the feel of the air is surreal like being transported into another dimension. I know everything and me is real, but the understanding of the chemistry/physics have confusingly altered- it doesn't seem to make sense like seeing something you've seen a million times feel like the first time and alien. Also, I lose all connection to an object of mine, maybe this is why I'm not that sentimental of a person.

It really gets crazy when my body parts don't feel to be me. I become numb to the parts and they just don't seem to be mine.

I'm weird.....I kinda like these moments because I'm weird that way, but at a point, enuff is enuff!