psychiatry

Identity confusion is defined by the SCID-D as a subjective feeling of uncertainty, puzzlement, or conflict about one's own identity. Patients who report histories of childhood trauma characteristically describe themes of ongoing inner struggle regarding their identity; of inner battles for survival; or other images of anger, conflict, and violence. P13

Steve [sports psychiatrist] had already taught me to try and stop worrying so much about pleasing everyone. We knew that this was one of my most draining flaws and he again used three groups to clarify my thinking. There would always be some people, Steve said, who would care about me and love me. In contrast there would also be a select group of people who would never warm to me - no matter what I did. And in the middle came the overwhelming mass who were largely indifferent to any of my failures or triumphs. I needed to understand that most people didn't really care what I did or said. All my anguish about how they might perceive me was redundant. Steve helped me realize that I spent too much time trying to please those oblivious people in the middle or, more problematically, the small group who would never change their critical opinion of me. I should concentrate on the people who really did show concern for me.

A psychiatrist is the God of our age. But they cost money.

SELFHOOD AND DISSOCIATIONThe patient with DID or dissociative disorder not otherwise specified (DDNOS) has used their capacity to psychologically remove themselves from repetitive and inescapable traumas in order to survive that which could easily lead to suicide or psychosis, and in order to eke some growth in what is an unsafe, frequently contradictory and emotionally barren environment.For a child dependent on a caregiver who also abuses her, the only way to maintain the attachment is to block information about the abuse from the mental mechanisms that control attachment and attachment behaviour.10 Thus, childhood abuse is more likely to be forgotten or otherwise made inaccessible if the abuse is perpetuated by a parent or other trusted caregiver.In the dissociative individual, __here is no uniting self which can remember to forget_. Rather than use repression to avoid traumatizing memories, he/she resorts to alterations in the self __s a central and coherent organization of experience. . . DID involves not just an alteration in content but, crucially, a change in the very structure of consciousness and the self_ (p. 187).29 There may be multiple representations of the self and of others.Middleton, Warwick. "Owning the past, claiming the present: perspectives on the treatment of dissociative patients." Australasian Psychiatry 13.1 (2005): 40-49.

My mother, my psychiatrist and an assortment of sedatives eventually convinced me I was delusional.

Can you smell his sweat? That peculiar goatish odor is trans-3-methyl-2 hexenoic acid. Remember it, it's the smell of schizophrenia.

Wilhelm Reich identified "armor" as the sum total of typical character attitudes, which an individual develops as a blocking against his emotional excitations, resulting in rigidity of the body, lack of emotional contact, "deadness". Functionally identical to muscular armor (chronic muscular spasms)

What daily life is like for __ multiple_ Imagine that you have periods of __ost time._ You may find writings or drawings which you must have done, but do not remember producing. Perhaps you find child-sized clothing or toys in your home but have no children. You might also hear voices or babies crying in your head. Imagine that you can never predict when you will be able to have certain knowledge or social skills, and your emotions and your energy level seem to change at the drop of a hat, and for no apparent reason. You cannot understand why you feel what you feel, and, if you are in therapy, you cannot explore those feelings when asked. Your life feels disjointed and often confusing. It is a frightening experience. It feels out of control, and you probably think you are going crazy. That is what it is like to be multiple, and all of it is experienced by the ANPs. A multiple may also experience very concrete problems, even life-threatening ones.

Since when did psychiatry become one big, fat Myspace survey?

I recently consulted to a therapist who felt he had accomplished something by getting his dissociative client to remain in her ANP throughout her sessions with him. His view reflects the fundamental mistake that untrained therapists tend to make with DID and DDNOS. Although his client was properly diagnosed, he assumed that the ANP should be encouraged to take charge of the other parts at all times. He also expected her to speak for them__n other words, to do their therapy. This denied the other parts the opportunity to reveal their secrets, heal their pain, or correct their childhood-based beliefs about the world.If you were doing family therapy, would it be a good idea to only meet with the father, especially if he had not talked with his children or his spouse in years? Would the other family members feel as if their experiences and feelings mattered?Would they be able to improve their relationships? You must work with the parts who are inside of the system. Directly.

Some alters are what Dr Ross describes in Multiple Personality Disorder as 'fragments'. which are 'relatively limited psychic states that express only one feeling, hold one memory, or carry out a limited task in the person's life. A fragment might be a frightened child who holds the memory of one particular abuse incident.' In complex multiples, Dr Ross continues, the 'personalities are relatively full-bodied, complete states capable of a range of emotions and behaviours.' The alters will have 'executive control some substantial amount of time over the person's life'. He stresses, and I repeat his emphasis, 'Complex MPD with over 15 alter personalities and complicated amnesia barriers are associated with 100 percent frequency of childhood physical, sexual and emotional abuse.' Did I imagine the castle, the dungeon, the ritual orgies and violations? Did Lucy, Billy, Samuel, Eliza, Shirley and Kato make it all up? I went back to the industrial estate and found the castle. It was an old factory that had burned to the ground, but the charred ruins of the basement remained. I closed my eyes and could see the black candles, the dancing shadows, the inverted pentagram, the people chanting through hooded robes. I could see myself among other children being abused in ways that defy imagination. I have no doubt now that the cult of devil worshippers was nothing more than a ring of paedophiles, the satanic paraphernalia a cover for their true lusts: the innocent bodies of young children.

Then the weeks rolled by in a sinister psych ward haze filled with white-coated orderlies and rocking whack-job patients torn straight from some old Jack Nicholson film, all anti-psychotic meds and padded lonely cells...

My sadness is beautiful. It infuses everything I do. It is at the core of my identity and always has been, just as happiness is in some people. I refuse to be told that it's a flaw. I will not mute it with medications for the sake of society. I will hold it close to me and celebrate it rightfully while the rest of the world fails to see it for what it is and it will be their loss.

If the mind fits, shrink it.

The anti-psychiatrists held various, sometimes conflicting views but one particular line of reasoning is attributable to all of them__hey all pitched their arguments against the power of the psychiatric establishment. They argued that the psychiatric diagnosis is scientifically meaningless. It is a way of labeling undesirable behaviour, under the guise of medical intervention. Those who are diagnosed ill are subjected to treatment which is a violation of human rights and dignity. The situation amounts to psychiatry having a mandate to declare some citizens unfit to live in an __rdinary_ community. It claims to cure but the supposed beneficiaries of that cure are often held in hospitals against their will. Within a structure like this it is impossible to understand the real nature of mental suffering and it is just as impossible to develop a coherent system of help.

Dissociation is characterized by a disruption of usually integrated functions of memory, consciousness, identity, or perception of the environment.

Dissociation is the ultimate form of human response to chronic developmental stress, because patients with dissociative disorders report the highest frequency of childhood abuse and/or neglect among all psychiatric disorders. The cardinal feature of dissociation is a disruption in one or more mental functions. Dissociative amnesia, depersonalization, derealization, identity confusion, and identity alterations are core phenomena of dissociative psychopathology which constitute a single dimension characterized by a spectrum of severity.Clinical Psychopharmacology and Neuroscience 2014 Dec; 12(3): 171-179The Many Faces of Dissociation: Opportunities for Innovative Research in Psychiatry

Imagine a psychiatrist sitting down with a broken human being saying, I am here for you, I am committed to your care, I want to make you feel better, I want to return your joy to you, I don't know how I will do it but I will find out and then I will apply one hundred percent of my abilities, my training, my compassion and my curiosity to your health -- to your well-being, to your joy. I am here for you and I will work very hard to help you. I promise. If I fail it will me my failure, not yours. I am the professional. I am the expert. You are experiencing great pain right now and it is my job and my mission to cure you from your pain. I am absolutely committed to your care... I know you are suffering. I know you are afraid, I love you. I want to cure you and I won't stop trying to help you. You are my patient. I am your doctor. You are my patient. Imagine a doctor phoning you at all hours of the day and night to tell you that he or she had been reading some new stuff on the subject of whatever and was really excited about how it might help you. Imagine a doctor calling you in an important meeting and saying listen, I'm so sorry to bother you but I"ve been thinking really hard about your problems and I'd like to try something completely new. I need to see you immediately! I"m absolutely committed to your care! I think this might help you. I won't give up on you.