[guilloche]

I've written about how my ex-T sent me for a dissociative disorders (DD) consult... and then terminated me when I was diagnosed (after promising he wouldn't) because he didn't have any experience with DDs and he thought I needed an "expert".

Fast forward almost 15 years. I had lost my copy of the report, and just got a copy from a different ex-T. And, it's worse than what I had thought.

I'm stressed and worrying. I want to share it with my current T. But...

1. Current T is not an expert in DDs either, and I'm scared to death he's going to feel like he has to refer me out for the same reasons. The diagnosis ("most likely DID") isn't what I remembered (I thought it was DD-NOS). This would really suck. Current T has been better than any of the other Ts I've seen (including "experts" in DDs) at working with me, and knows much more of my history. It would be really awful to lose current T over this

2. The report seems pretty awful. As in, I don't really recognize "me" in it. It's confusing. There's also a lot that I don't understand, and that Google isn't helping much with ("impaired self reference?" huh?).

And... I don't understand why nobody really talked through this stuff with me when I had the consult done. I did a final session with the consult-T, so maybe I just didn't hear it, but I don't remember getting a good summary, or having a chance to ask questions .

3. I'm sure there's something missing. I could have sworn that consult-T originally gave me a page that showed graphs of my responses, compared to those of people who were hospitalized with DID. That's not in here. I thought she had written something about a "child part", but it's not in here either. I'm confused about the missing pages!

I really wish I had dealt with all this back when I did the consultation. It was such a hard time though, and I was really hurt and upset that the woman who did the consult couldn't take me on as a client. I liked her and thought she would have been fantastic as a T, but she was too busy writing a book . I tried a bunch of referrals, and none of them worked for me. Some were pretty awful.

I don't know... I'm stressing over this and guess I just needed to talk a little about it... not the kind of thing you can talk about with co-workers !

Thanks...

[ThisWayOut]

r Reading reports can be stressful. That said, it is 15 years old, you are likely in a different space now. There are many reasons you may remember it differently from what you have now, one may be the level of dissociation you were experiencing at the time.
It might be good to show current t just to be able to talk about it, but you may want to lead with how anxiety-provoking that is and why. I think your t sounds aware enough to have noticed if something with you was making him uncomfortable or feel out of his element. The fact that you have gotten so far with him says volumes about the fit at least in the present moment...
I have documents from as recently as 5 years ago and I'm miles away from there (though it doesn't always feel like it)... even if you don't show him the actual report, you can always talk about what it brings up.
I would hate to see you lose this t over something like this, so go with your gut. But also keep an open mind that he may still be okay seeing you because an old report doesn't negate all the work you guys have done through now...

Wow. A diagnosis, handled inexpertly (as yours was) can be devastating. First, to have your therapist at the time drop you; and now, to find out it's worse than what you thought.

Two thoughts:
1) MH providers/evaluators are not gods. They get things wrong, and they don't always agree, either.
2) If your current therapy is going well, is there a reason you would need to share this? After all, your therapist is treating you, not the opinion of an evaluator from 15 years ago that may not even be accurate.

[unaluna]

I think the field has advanced a lot in the past 15 years, so there is that, too. I can tell my t has a different understanding of the subject than when we started together ten years ago.

[guilloche]

Thanks. The whole thing is/was just crazy. That was the old T that apparently didn't actually *believe* in dissociative disorders (unknown to me). I wasn't trying to get a diagnosis... I had just started reading things online, and came to him saying, "hey! Look! This sounds like me!". At which point he said... "OK, so... you mentioned the d-word...." Totally threw me that he didn't even want to say the word "dissociation". What... the heck?

Later, after the consultation (my last session) he apologized and said it was a knee-jerk reaction, and that he should have listened to me. The whole thing was kind of awful though. Before the consultation, I had specifically asked if I ended up with a diagnosis, if he was going to kick me out... and he said, "Absolutely not. This is just so that we can better plan your treatment." Hey! Great - I'm all in favor of better planning my treatment. Then after, "Well, I feel like it's a mixed signal to tell you that you need to see an expert, but to keep seeing you... "

This was all a couple weeks, literally, before I started grad school, so my life was pretty chaotic anyway. I know I had a final session with consult-T (that's not listed on the report), so I assume she tried to go over it with me... but I don't think I really took any of that in *Ugh*.

I guess, aside from my T giving up on me, I worry that maybe the consult-T was right (this was like... *5* different tests, with all kinds of subscores and t-scores and weird things) - and that that stuff doesn't just disappear on it's own. Maybe I should see a specialist... except I tried that, several times, back after the consult - and none of them were helpful. Several were downright *awful*.

I actually think my current T would be fantastic for dissociative stuff... he's actually much better than previous Ts at not pushing when I start to get spacy, and is starting to recognize it, I think. We've talked about some of it. And, I had just sent him an email after my last session to let him know that whatever question he asked that I answered with "I don't know, I'm blanking out" - I couldn't remember the question at all (a couple hours after the session). So, he's aware of that stuff.

ThisWayOut - thanks. I am in a different space, I'm more stable right now but I think it's because I *stopped* therapy, and just focused on work and saving money and being stable! I don't know, I guess I feel really unable to say "yeah or no" - you know - like, I don't know, I'm not the one with training in this stuff, I don't know what's wrong with me! I also think that as we get into actually doing more therapy, and less of the initial "establishing the relationship" - things might get worse again?

(Ha! It's kind of something I tried to explain to my T early on, when he said something like, "you don't seem dissociative?". I told him, "well yeah - if we're having a non-scary conversation, of course I don't. There's no need to dissociate if we're talking about kittens!")

LicketySplit - thanks. Yeah, I think I want to share it with him... because I've talked alot about it already. It was really frustrating for me to not be able to find my copy, and I think it might be a dissociative thing in itself (I assume that I threw it out, but I don't remember doing that, and I can't understand how I ever would have thought that was a good idea - given how expensive and thorough the testing was!)

Hankster - thanks!

Thanks guys. I know I'll end up giving it to him. I've been really working hard to not hide stuff from him, which is (obviously) incredibly hard. I don't know how he'll react, so I'll definitely preface it with my concerns. And then I'll tell him he needs to go away, read it, and come back and translate all the psychologese into english for me

*sigh*. Nothing's ever easy.

[guilloche]

Adding... I had asked that original T, at my last session if he believed this (i.e. the diagnosis), because it felt a bit extreme to me. I asked him if it was possible that consult T, being very specialized in working with dissociative stuff, might possibly interpret things that way and over-diagnose? He (he who did not believe in DDs before this) said that he thought it was accurate, and if he were called to court to testify, he'd testify to it. Yikes.

Oh, and I know he didn't believe in DDs previously, because one of the Ts that I saw after that heard it from consult-T. Ex-T told consult-T who told my T who told me (!!!) - ex-T didn't believe in dissociative disorders until going through this with me .

[junkDNA]

to me, diagnoses are crap. the important thing is just managing symptoms and finding healthy ways to cope and make progress. i dont put much stock in diagnoses obviously. but, thats just me

[SnakeCharmer]

This report is 15 years old and the whole concept of DID has changed and been refined and ... well, that report might just be a load of bullbucky. Seriously, 15 years ago people were using screenplays as textbooks for DID.

And this bit:

I know he didn't believe in DDs previously, because one of the Ts that I saw after that heard it from consult-T. Ex-T told consult-T who told my T who told me (!!!) -

That's convoluted gossip akin to the old telephone game. Who knows how the message got mangled in those four repeats?

Maybe the thing that's worth talking about with current T is that you're still upset about the way things went down 15 years ago and you can't get it out of your mind.

I once burned a consult report on me that said I had blahblahblahyadayada because I was 40 years old and had no biological children and no woman could be fulfilled as a human being without bio children and the fact that I'd made that a choice -- I was practically a danger to society and I needed to learn to be less assertive and more submissive to proper male authority. That was before the days of electronic medical records so nobody will ever see that report. Maybe I should have kept it as evidence in an art exhibit on sexism in medicine. IDK. All I'm saying is you don't have to believe everything that's written about you.

Personally, Gillouche, I would not even let you current therapist see that evaluation. The fact that it is fifteen years old is truly significant. Diagnosis of Dissociative Disorders has changed so much over the last ten years that it is probably a useless piece of paper! Go forward from where you are now and work on the things that you feel are important and affecting your life in the here and now.

I was diagnosed with DDNOS only six years ago during a inpatient stay. I know deep in my heart that the diagnosis was wrong. Yes, I dissociate, but the march to find people with DID and DDNOS was crazy for a while. I believe that there are people with DID and DDNOS but I don't think that the number of people who are being diagnosed with them are accurate. If you don't feel that you fit the diagnosis and feel comfortable and supported in the relationship you have with your current therapist, I'd suggest just walking away from the evaluation. ANY and All evaluations are the single judgment/conclusion of ONE evaluator. It takes a lot more than one person to convince me of something that I'm having trouble accepting!
Hope things work out for you.

[guilloche]

thanks. i talked to him today. he doesn't care, he's not going to kick me out over this, he read it in session and said it really doesn't add much new to his understanding of me, and he trusts his own experience with me more than the report. but, he also didn't seem to be familiar with alot of the terminology (anoetic, impaired self reference).

i get what you are all saying about the validity, but... the person who did the assessment is a well-known researcher/T in this area who (if i understand correctly) has helped form the current understanding of dissociative stuff. the assessment looks pretty thorough:
- TSI (trauma symptoms inventory)
- modified PTSD symptom scale
- dissociative experiences scale (DES)
- somatoform dissociation questionnaire (sdq-20)
- structured interview for dissociation (scid-d)
- multidimensional inventory of dissociation (mid) - which was new at the time.

the stuff that she says makes some sense to me. it concerns me. every way that i think about it concerns me. if my T knew about this stuff and could say yeah or no, that would be helpful, but when he says, "oh well i'm a phd and she's not, so i don't really believe her" that doesn't seem useful. or when he says that he doesn't understand the terms she's using in the report.

i tried, after getting the consult, to find a good t who knew about this stuff. it just didn't work out for me. there were a couple of really awful Ts in there. just no luck. this was all back in 2001. it feels so long ago. my ex-t at the time did apologize for not believing me about the dissociative stuff, he said "I should have taken you seriously, it was a knee-jerk reaction b/c I think it's over-diagnosed". I asked him if he thought the consult was right, or if he thought she was just over-diagnosing, since it's her specialty and he told me that he thought it was accurate, and if he were called into court, he'd say so under oath.

just feels like i can't win here. maybe i should just leave it alone. kind of don't think therapy is ever going to work for me. i don't think i have in me whatever it is that lets everyone else go and do whatever it is you have to do to get a benefit from it. i'm at almost 8 months with this one, just don't see hope or improvement or feeling like there's a plan.

sorry, just sad tonight after therapy today, and no where else to go with this. i did have piano lesson tonight, and piano teacher is good with my sadness... helped me find some nice sad (minor-key jazz) to work on, it helps... thanks for listening....

[ThisWayOut]

sorry it didn't bring any relief to talk to t. I think if you are really worried about it, maybe see if you can get an updated consult?
I think if t seems willing to still work with you, and is pretty much his understanding of you, then maybe you need to now focus on a game plan? What do you want from therapy with him? what are your expectations? Do you want to handle anything in a certain way?
keep playing. And keep up with therapy for now. Maybe bring up what you thought was helpful with t's response, and what wasn't. If you need to talk more about the report, then do it... sometimes we need to talk about things over and over again until it all makes sense.

[guilloche]

Thanks ThisWayOut. You're right about keeping up with therapy, it's just... so hard. Like, literally every 2nd or 3rd session I'm feeling bummed out and want to quit. I was in tears last night, not just about the report, but feeling like he really didn't listen/get it when I talked about falling last week (I fell outside, twisted my ankle, couldn't get up b/c it felt like I was about to pass out, ended up lying in the parking lot in front of my condo for a bit until the dizziness passed... ). Really depressing. I end up not feeling understood/heard/cared about

Oh, and he was saying something about my brother (addict, in jail) again... and how great it is that I write to him, because nobody else will. Every time we talk about this, I think he has a much easier time empathizing and caring about my brother than me (he treats a lot of addicts in his practice). Brother was a bit of a crazed lunatic (violent) growing up, so it's a little bit of a weird dynamic .

Thanks

[ThisWayOut]

wow, I think I would have trouble with T empathizing more with a family member than myself. You are there for you afterall, not your brother or anyone else. <3

That fall sounds scary! I'm sorry he was so dismissive about it. Can you talk to him about not feeling heard? I know I have left T sessions feeling that way myself. Sometiems I was able to bring ip up later with the T and talk about it. It helped to clarify what I was looking for from T when I would talk about certain things. The ones I did talk to about it seemed to get it and help me feel heard. Sometimes T's need help in understanding us better. They are not mind-readers afterall. Sometimes they focus on things we don't much care about, other times they pick the "right" thing to focus on. It's a matter of developing the relationship and getting to know each other.
Hope you can figure things out with T again. Maybe write about it and take it in? or call him and try to get some connection that would make it easier to get through the next week?
I can relate to this feeling a lot Sometimes T sessions just end up leaving us feeling lacking...

[guilloche]

Thanks ThisWayOut, I really appreciate the hugs and empathy right now. I'm kind of feeling like a bit of a mess. I'm going to have to think about how to bring it up, I feel like every other session I'm having to tell him what he did wrong... he deals with it fine, usually, but I feel like it's getting to be a lot, you know? *thanks*