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Question Jul 10, 2013 at 10:09 AM
  #1
I have quite a bit of education around trauma and trauma reactions... Intellectually, I know dissociation can come in a lot of forms, and that there is no "true" form of dissociation, but more along a continuum of severity...
yet this (new) sexual assault clinician has said to me (twice now) that my dissociation is not considered "true" dissociation because it is not experienced like the traditional "out-of-body" experience is described (watching the experience from outside of my body).
I don't know why it bothers me, other than it is very invalidating to the experience itself, and what other (more expert) clinicians and doctors in the field of trauma have told me... While I am desperately grasping for any support I can get, I'm beginning to wonder if seeing her will be more helpful or hurtful. Has anyone else been told that their experience of dissociation is not "true" dissociation? I'm not quite sure what she is trying to achieve by telling me this more than once. I don;t know how to ask her why her definition is so limited, and why she feels the need to underscore this with me. I also don't know why it is getting under my skin so badly... Maybe it's a fear of trusting yet another person... and fear of judgement from her (is she being judgmental?)... and maybe a fear of her invalidating the entire experience. I have felt like I needed to defend myself with her in terms of my interpretation of events that occurred, and why I did not leave/felt like I could not leave the situation. But she is supposed to be an expert in this arena... I don't know. She's willing to still see me, despite general policy not to "duplicate" services (I don't feel I can talk about this with my T because he is a male T, and there are so many other daily things that we need to tackle... and he is also looking to help get me extra support). I agreed to keep an open dialogue with both of them. Maybe I will talk to her next week and ask about this...
Am I wrong in my understanding of dissociation? I used to know a lot about this, but since everything has relapsed, I find it hard to remember facts about treatment and such... this may be one of them...
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Default Jul 10, 2013 at 10:26 AM
  #2
I'm not an expert on this subject at all, but it sounds to me as if maybe your clinician is threatened in someway because you are knowledgeable about this and want honest answers that she might not be able to give you.Intellectually it sounds like you have a good perspective on what is true disassociation and it would seem invalidating, if you are confident in what you know, yet open to further discussion. getting a second opinion might help.
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Default Jul 10, 2013 at 11:13 AM
  #3
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Originally Posted by MdngtRain View Post
I have quite a bit of education around trauma and trauma reactions... Intellectually, I know dissociation can come in a lot of forms, and that there is no "true" form of dissociation, but more along a continuum of severity...
yet this (new) sexual assault clinician has said to me (twice now) that my dissociation is not considered "true" dissociation because it is not experienced like the traditional "out-of-body" experience is described (watching the experience from outside of my body).
I don't know why it bothers me, other than it is very invalidating to the experience itself, and what other (more expert) clinicians and doctors in the field of trauma have told me... While I am desperately grasping for any support I can get, I'm beginning to wonder if seeing her will be more helpful or hurtful. Has anyone else been told that their experience of dissociation is not "true" dissociation? I'm not quite sure what she is trying to achieve by telling me this more than once. I don;t know how to ask her why her definition is so limited, and why she feels the need to underscore this with me. I also don't know why it is getting under my skin so badly... Maybe it's a fear of trusting yet another person... and fear of judgement from her (is she being judgmental?)... and maybe a fear of her invalidating the entire experience. I have felt like I needed to defend myself with her in terms of my interpretation of events that occurred, and why I did not leave/felt like I could not leave the situation. But she is supposed to be an expert in this arena... I don't know. She's willing to still see me, despite general policy not to "duplicate" services (I don't feel I can talk about this with my T because he is a male T, and there are so many other daily things that we need to tackle... and he is also looking to help get me extra support). I agreed to keep an open dialogue with both of them. Maybe I will talk to her next week and ask about this...
Am I wrong in my understanding of dissociation? I used to know a lot about this, but since everything has relapsed, I find it hard to remember facts about treatment and such... this may be one of them...

are you wrong in your understanding of dissociation? Im sorry but we cant answer that... you see each location, mental health agency, religion, culture...all have their own definitions of the same words..

which may be why this treatment provider is telling you different then what you believe. it may very well be the belief with in the mental health program where you are, the mental health agency at which this treatment provider works,...that what the treatment provider described is what dissociation is where you are....

my suggestion ask the treatment provider to show you the medical and mental health definition of what dissociation is in your location.. its usually wrote down in diagnostic books, mental heath treatment pamphlets, the Physicians Desk reference, the IDC coding and other professional manuals your treatment providers use...

this way you will have the terminology that is professionally appropriate for your location, religion, culture....what ever your treatment providers go by in treating you.

another suggestion... it helps to have all treatment providers in contact with each other when being treated by more than one treatment provider, this way problems like conflicting definitions, conflicting treatment plans, conflicting meds and other conflicts are avoided..maybe you can give this treatment provider contact with your other treatment provider so that they will both be on the same page with definitions, treatment and such.
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Default Jul 10, 2013 at 03:35 PM
  #4
as for getting them in contact with one another, this T is seeing me despite her program policy not to "duplicate" services. When I asked if she wanted a release of info for my primary T, she said that it was not necessary, but that I should keep open dialogue. I'm hoping if she is going against company policy, she will talk to one of her supervisors and ok it all.

about the different definitions around dissociation, I was under the impression that most of the US used the same one, but I guess it's not accurate. I might ask her next week to help me understand her def. and to figure out why she is so adamant about changing my understanding of it.
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Default Jul 10, 2013 at 04:00 PM
  #5
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Originally Posted by MdngtRain View Post
as for getting them in contact with one another, this T is seeing me despite her program policy not to "duplicate" services. When I asked if she wanted a release of info for my primary T, she said that it was not necessary, but that I should keep open dialogue. I'm hoping if she is going against company policy, she will talk to one of her supervisors and ok it all.

about the different definitions around dissociation, I was under the impression that most of the US used the same one, but I guess it's not accurate. I might ask her next week to help me understand her def. and to figure out why she is so adamant about changing my understanding of it.
I think you should also tell her how it made you feel when she twice told you that you do not have "true" dissociation. I think sometimes therapist speak to us as though they are teaching a class. If she was thinking she should have discussed the differences between what she thinks is dissociation and what you understand dissociation to be. Than ask you how you felt about the discussion.
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Default Jul 10, 2013 at 05:08 PM
  #6
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Originally Posted by MdngtRain View Post
as for getting them in contact with one another, this T is seeing me despite her program policy not to "duplicate" services. When I asked if she wanted a release of info for my primary T, she said that it was not necessary, but that I should keep open dialogue. I'm hoping if she is going against company policy, she will talk to one of her supervisors and ok it all.

about the different definitions around dissociation, I was under the impression that most of the US used the same one, but I guess it's not accurate. I might ask her next week to help me understand her def. and to figure out why she is so adamant about changing my understanding of it.
dissociation by its self (not to mental disorder extreme) has many different definitions....

for some it means they feel a bit spacey from their meds
for someone else it means they feel kind of slow as if in slow motion movie because they didnt get enough sleep
for others it means floating on the ceiling watching whats going on (out of body feeling)

As a dissociative disorder (depersonalization/derealization disorder, dissociative amnesia/fugue disorder, Dissociative Identity Disorder, Unspecified Dissociative Disorder or Other Specified Dissociative Dissorder) yes there are diagnostic criteria that says what each of those dissociative disorders are, that all american treatment providers go by unless they are going by the ICD.
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Default Jul 13, 2013 at 11:03 AM
  #7
What bothers me the most is that you went to her in the first place to deal with sexual abuse - why is the therapist sidetracking on definitions?!? I know you need to deal with background, etc. but this seems off topic and not helpful. This work is hard to do - much less with someone who wants to argue and get into power struggles. I sense she is somewhat intimidated about the co-therapist situation and may not be the best fit for you. Some therapists are just not a good fit, and it is ok to "interview" several people for the job before making a decision on who you go with. Just sayin...
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Default Jul 13, 2013 at 02:25 PM
  #8
MomgaJupiter, I'm limited in choices with respects to this, as she was the therapist assigned to me when I called the center... and since they have a policy against duplicating services, I'm stuck with her. I was hoping to talk more with her about this on Tuesday, but she had to reschedule because she will be out of town for the week (something I think you generally know about before-hand, but maybe something urgent came up. I'm trying not to internalize that). I think we will def need to address the 2 therapist thing again, and I will ask that she talk to him and the other way around also. I want them to be on the same page...
I'm really putting a lot into this therapy because I know I really need to talk about this stuff. It's a bit intimidating knowing that, if her boss decides it's not appropriate, I will lose this resource too... :/
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Default Jul 14, 2013 at 07:13 AM
  #9
Work out what bothers you so much about what she said. Maybe write it down and give those questions and feelings to her. She may not know that it is making you feel invalidated or less than. Pain is Pain no matter what your experience is classified as.

Hopefully when you do chat with her things will be made clearer.

Good Luck.
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Default Jul 14, 2013 at 09:39 AM
  #10
I guess I don't have anything to "add", just encouragement to tell her your concerns and to tell her how her statement(s) made you feel. Using the word "true" in that would bother most people when used to define a personal experience that you also have knowledge of---it sounds as if she is "correcting" you, or invalidating your experience even if it was not meant that way at all. It is amazing what words can do, and undo. Good luck to you! Be thinking of you.
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Default Jul 14, 2013 at 07:27 PM
  #11
I also say, talk about it. On a few occasions I have been able to tell my T how a way he described my symptoms/experience affected me negatively. It's been very helpful for both of us, I think--he can't know that something could be hurtful unless I tell him, and I doubt he uses those phrases again with other clients now. I hope sharing your feelings is a positive experience.
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Default Jul 19, 2013 at 08:28 PM
  #12
[quote=MdngtRain;3161544]I have quite a bit of education around trauma and trauma reactions... Intellectually, I know dissociation can come in a lot of forms, and that there is no "true" form of dissociation, but more along a continuum of severity...
yet this (new) sexual assault clinician has said to me (twice now) that my dissociation is not considered "true" dissociation because it is not experienced like the traditional "out-of-body" experience is described (watching the experience from outside of my body).

MMMMMMMMMMM some people go inside to hide. Maybe an "in body" experience. Her statement bothers me too.

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Default Jul 24, 2013 at 09:10 AM
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I didn;t have to worry about talking to her about it. Yesterday's session was quite revealing in her attitude and I'm not going to see her again. She pretty much dismissed me and my issues all the while telling me she is not judgmental. She made it very clear that any overt symptoms of ptsd will lead to an involuntary commitment. She harped on involuntary commitment for a good 20 minutes out of a 30 minute session (I left early). She was very contradictory in what she said from moment to moment. She also said I will never find an inpatient treatment center that will not force meds onto me. She made me feel totally hopeless and broken... I'm glad I still have my regular T...
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Default Jul 24, 2013 at 10:28 AM
  #14
I'm so sorry you had to go through that!! Remember that it is not you, it is her inability to help that is probably causing this. Or rather, her inability to see things in another way. At the s/abuse clinic I go to, there are a couple counselors that are really nice. There's also one lady that is extremely serious and opinionated. I'm lucky that I have the choice to not see her. She was telling me one day about all the different things she can teach me, should I choose to do longer term counseling with her. She also is the one I hear most saying negative things about other staff, AND other clients (although she doens't mention names).

I feel as though some women go into the job with past experience, so that they can help. However, their idea of helping includes a lot of judgements attached, and is sometimes fuelled by anger. It makes me really sad to think of the many women coming in feeling vulnerable and needing support, and they are often too busy in their internalized fight for justice, and preconcieved opinions, to be able to help out.

Hope you can focus on some self care today, treat yourself to something you enjoy: a bubble bath, candles, good movie/book, special treat.

IJ
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Default Jul 24, 2013 at 07:55 PM
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I didn;t have to worry about talking to her about it. Yesterday's session was quite revealing in her attitude and I'm not going to see her again. She pretty much dismissed me and my issues all the while telling me she is not judgmental. She made it very clear that any overt symptoms of ptsd will lead to an involuntary commitment. She harped on involuntary commitment for a good 20 minutes out of a 30 minute session (I left early). She was very contradictory in what she said from moment to moment. She also said I will never find an inpatient treatment center that will not force meds onto me. She made me feel totally hopeless and broken... I'm glad I still have my regular T...
I went through a few therapist before I found one that fit. This doesn't mean the prior therapist were bad, it just means that they weren't good for what I need in a therapist. One of my therapist thought it would be a good idea if I took a plastic bat and hit a blow up punching bag during session in her office. Even after I explained that I was capable of becoming very rage-full and I could not be certain that I could control the level of rage that could be brought out by hitting something with a bat. She gave no consideration to what I told her. I went home that night and began to look for another therapist. One that listened to what I was saying and I am still with her now.
The right therapist is out there, you just have to keep looking until it feels right. Good luck.
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Default Jul 25, 2013 at 03:45 AM
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'"I have quite a bit of education around trauma and trauma reactions... Intellectually, I know dissociation can come in a lot of forms, and that there is no "true" form of dissociation, but more along a continuum of severity..."

Trust ur intuitive self! Any clinician who says u are not truely dissociative, obviously is not familiar with the full spectrum of diagnostic criteria. I personally was diagnosed with DID NOS which is disssociative identity disorder not otherwise specified.
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Default Jul 26, 2013 at 10:48 AM
  #17
I know you said that this t was bending the rules in order to see you, so just getting out and getting a new one would not be easily done. But at least if one t was, there might be another one somewhere..
I'm lucky that where I am I use a few different agencies for support, and it's all government funded. They don't communicate with each other but they're aware I use different services. I guess the way I started was calling help lines - the ones where they hire professional crisis workers/counsellors to answer the phone. Over the last 6 months they've gotten to know me on both lines that I call, and always help me with resources. Like I said, I'm very lucky!! But also stubborn, something that I needed to make it through the health system until I found the right people.

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