Today is two years to the day that I started seeing my therapist. I wrote her a letter that I’ll be reading in session later today and I wanted to post it here as well:
Tag: dissociative identity disorder
I had a very hard time sleeping on Monday night. I think I was nervous about my job interview Tuesday morning, but I was also just extremely agitated. I couldn’t get comfortable and I felt something that I struggled to identify. Loneliness? Grief? Sadness? Emptiness? Anger? All of the above?
I’m not sure.
When I mentioned it to my wife and we spoke about it, she said that she believed she briefly spoke with a part that she’s never talked to before. She guessed perhaps it was Scooter because this part seemed young, but also very angry, expressing intense anger at my therapist for leaving us (i.e. going on vacation). Interesting.
The interview went very well. I wasn’t particularly nervous for the actual process of being interviewed. My résumé is stellar and I have a charismatic, articulate, confident presence that tends to impress people. I also went into the interview knowing I’m a very good match for the company, so I was more or less scoping them out to see if it seemed like a good fit for my career trajectory. I ended up being quite impressed with the two interviewers. There was a moment when I could tell they switched from “interviewing” me to “selling the job” to me, which felt nice. I love the idea of being a prize candidate and I’ve worked damn hard for it!
Things have been so strange in therapy lately. I think we recovered fairly well from the whole “Google” incident, and I was able to talk to her openly about what it meant to have Grey Mouse as a transitional object. Although that conversation was upsetting because she sorta went in a different direction than I did.
I’d imagined she’d offered me the doll to help hold onto her and our work over that weekend. She did, but the thing she identified *first* was how she believed that taking care of the doll might help me connect with the part of myself that has such incredible love and compassion for my nieces and nephew. In essence, she was hoping I could channel that into compassion and love for myself, in particular the younger parts of myself.
Which is a good idea, but it felt like a rejection. And then I felt embarrassed for thinking she’d offered it to me to help connect with her (as opposed to myself). She clarified that it was for both reasons, but by that point all the warm fuzzies I’d felt from the original gesture were gone and I hastily threw the doll back in his normal resting place on the ottoman in her office.
As I mentioned in my last post, my therapist lent me a stuffed animal to use as a transitional object for this weekend. I have session this afternoon and I’ll have to bring Gray Mouse back to her office.
It’s been interesting to have him with me the last three days. I think that my relationship with this stuffed mouse has somehow been a recreation of the relationship I have with my therapist. (Maybe that’s the point?)
It’s hard to explain, but I feel a lot of restraint around it. I know it’s here and that I can ultimately love it or hate it as much as I want, but I am cautious and protective of myself. I feel almost afraid to truly allow myself to feel connected to the doll and what it represents, which is the connection I have with my therapist and our work together.
I can tell that there is a part (or parts) of me that feel a desperate and unfiltered attachment to this doll. But I can also feel the skepticism and restraint that comes from other parts. So although it is literally just a stuffed animal, I find myself feeling a lot of complicated emotions around it.
I haven’t let it out of my sight since she gave it to me. It’s generally been within arms-length of me the entire weekend. I even slept with it, alongside my other stuffed animals. My wife suggested that Gray Mouse could befriend some of our other toys and I was incredibly resistant to this idea. It felt like too much – like something that wouldn’t (or shouldn’t) be allowed. I think I was trying to figure out exactly how my therapist would want me to utilize this gesture and what she would and would not approve of me doing with the mouse.
At this point, I believe I have seen my therapist for 202 sessions. That’s a lot. In all of those sessions, I have never asked her for any sort of transitional object. Partly because I’m afraid to ask and partly because I wouldn’t know what to ask for.
She has a very plain office, void of almost anything personal. I often sneak a glance at her bookshelf to see the titles, but I believe it’s entirely professional texts and nonfiction selections.
She also has maybe five tchotchke type items and I never pick them up or ask about them. And she has a single stuffed animal, a gray mouse, that made a mysterious appearance in her office several months ago. The mouse is generally resting in various positions nestled on or between the three pillows she keeps on top of an ottoman. I have laid down on the floor a couple of times and when I do that, I usually grab a pillow to place my head on.But otherwise I’m too afraid to touch anything else. I don’t want to be intrusive or get called out for being “nosy”.
Until today. Today I was in “rare form” (as my parents would say) and I felt curious about everything. I think it may have partially been a way to distract from myself and what was going on with me, but I also just felt an uninhibited curiosity that I wanted to explore. So I picked one item up at a time, brought it back to my chair, held it and played with it, and asked her about it. There wasn’t much to say, but she was kind and forthcoming with the conversation. I think she was curious herself, about my strange behavior.
Finally, I allowed myself to reach for the gray mouse. Or, Gray Mouse, as Anna (our 7 year old part) formally calls him. I’ve never actually touched him myself. I usually avoid looking at the toy because it activates that child inside and it distracts me. I don’t like feeling connected to the young parts. Their vulnerability and insatiable needs are frightening to me. But I grabbed him and held him close to my heart for about half of the session.
It was an interesting session. I felt dissociated from almost everything, which allowed me to speak in the kind of open and honest manner that I normally only wish for. I shared some things I’ve been holding onto for a long time. I asked my therapist some simple (and somewhat “personal”) questions I’ve been wondering about more or less since I met her.
It was nice, but also quite raw and painful. I can tell that we are at a crucial point right now. I am incredibly emotionally vulnerable for myriad reasons, including the nature of our current relational work and the possible transitional state of my self-destrutive impulses (from restricting back to cutting, drinking, using, etc).
As our session wrapped up, I could tell she sensed how intense I was feeling. She asked about my plans for this evening and the weekend, most likely checking in for safety and stability purposes. But then she said,
“This might seem like a strange question, but do you want to take Gray Mouse home with you and take care of him this weekend?”
I felt that little girl inside of me absolutely squeal with delight. I let out this sound that I cannot even describe and said, “Really?! You would let me take him for the weekend?!!”
I was damn near hysterical with joy. I looked up and saw my therapist beginning to become misty-eyed. I’m not sure what she expected in response, but I think she was somehow very touched by the moment.
“Yes. But you have to take care of him and make sure he doesn’t get hurt. You have to take care of each other.”
I squeezed that mouse with everything I had and told her I would take excellent care of him before stashing him gently in my bag. I don’t really feel much of anything right now, but I’m hoping I can “unthaw” a bit and pull out of this dissociated state some more so that I can really use this object to feel connected to my therapist throughout the weekend.
I really, really need that.
I am River
I am River.
I’m a fat fucking loser. I hate myself, every minute of every day. It feels like I’m constantly being crushed by myself.
I have an eating disorder. It’s my fault that I have it. I chose to starve myself because I wanted to make my parents angry. I wanted to make everyone angry. I wanted to make everyone as afraid as I am. But now it’s not a choice. It doesn’t feel like a choice.
I don’t get to make any decisions. The eating disorder makes all of my decisions. I know I want to be a child. I want to be small and skinny. Light. Invisible. Weightless. My eating disorder is so loud. I don’t think it started that way. At first, it was just a whisper. It was sweet and it promised me all the things I wanted. I wanted to be safe. I wanted to be a kid. A real kid. I didn’t want to think about scary, adult things. I didn’t want to have to make hard decisions and I didn’t want to be responsible for my choices.
The disorder promised me all of those things, as long as I followed its rules. Then there were more rules. At some point, I think I didn’t want it anymore, but it’s stronger than me. It’s louder than me. And I needed it to drown out everything else, everything that scared me. And it worked, so I guess I became superstitious. Now I’m a slave to it.
Today in session, I was telling my therapist that I feel like I’m at some sort of therapeutic plateau. I have come so far in terms of stability. I am in a good place – my life is overall quite wonderful. Of course there’s a lot I still struggle with, but that is entirely internal at this point. I have eliminated all sources of truly toxic or harmful external stresses. There is no one left in my life who can, or would, hurt me.
So, naturally, I feel a compulsion to continue to hurt myself.
During last night’s session, I nearly had a flashback. I think the only thing that stopped it was that I felt it coming on and mentioned that fact to my therapist. She told me that she knew it would annoy me, but that she was going to do what she needed to do in order to keep me “in the room” with her. For us, that means she asks a lot of grounding questions and makes a lot of grounding statements.
Why is this annoying? Because it feels like an abandonment. Not necessarily from me, but from the parts that are stuck in trauma time. I want to pull away from the memories and sensations, but unfortunately that means that I leave those traumatized parts stranded in their present-day torture.
Which sucks. But I just can’t do it. I can’t go there.
In an effort to attempt to get some of my therapy paid for by out of network insurance coverage, I asked my therapist to write me up invoices for January and February. We briefly discussed what diagnosis codes she should use. I was overwhelmed by the conversation at the time and ultimately indifferent to the code choices. I just told her to write whatever seemed most appropriate.
Today she gave me those invoices. Here’s a screenshot showing the codes she chose:
90834 is a CPT code just indicating that she sees me for individual psychotherapy.
F44.81 is an International Classification of Diseases, 10th edition (ICD-10) code. I honestly wasn’t sure what my therapist would put for this. I figured it would be genereric, like “anxiety disorder” or “mood disorder – unspecified”, which is what Zooey always listed on her invoices, and what my psychiatrists frequently use.
But I looked up the code and here is what it says online:
F44.81 – Dissociative Identity Disorder
This is a specific ICD-10-CM code that can be used to specify a diagnosis. This is the American ICD-10-CM version of F44.81. Other international ICD-10 versions may differ.
- A disorder characterized by the presence of two or more identities with distinct patterns of perception and personality which recurrently take control of the person’s behavior; this is accompanied by a retrospective gap in memory of important personal information that far exceeds ordinary forgetfulness. The changes in identity are not due to substance use or to a general medical condition.
- A dissociative disorder in which the individual adopts two or more distinct personalities. Each personality is a fully integrated and complex unit with memories, behavior patterns and social friendships. Transition from one personality to another is sudden.
Applicable To: Multiple personality disorder.
ICD-10-CM F44.81 is grouped within Diagnostic Related Group (MS-DRG v32.0): 883 Disorders of personality and impulse control.
I know this is not news to you (or me), but this is the first time I have ever actually seen this on paper for myself.
This is real.
I really have this. I have officially (on paper I can see with my own eyes) been diagnosed with Dissociative Identity Disorder. My therapist believes me. And she believes me with enough conviction to bill my insurance using that specific code.
Holy shit. I have a lot of feels right now.
Last week was my birthday.
I told my therapist in the session leading up to it that I’d need her support. I wasn’t able to articulate exactly how or what she could do to help, but I knew it would be a difficult week. My birthday is always hard for me, for us, as a system. There are difficult memories and emotions that come up in a seemingly unavoidable way each year.
But things have also been very difficult for River lately. She’s been showing up in session more, talking in a really open and honest way that makes me, my wife, and my therapist very happy. It has made it kinda worse in terms of having an eating disorder, but my therapist is convinced this is all part of the recovery process.
So on Wednesday, River went to session. I’m not entirely sure what was discussed, but I know she ended the session by asking my therapist if we could call her the next day to check in. Apparently my therapist hesitated just long enough for River to feel something that was upsetting. My therapist told me she said, “Ugh, never mind” before more or less storming out of the office.
And then she didn’t call our therapist. No one did. Which sucks because I know I could have certainly used the added support.
I hate February.
I was born in February. Late February.
I have many trauma anniversaries. Probably at least one for as many days as there are in a calendar year. It’s hard to imagine that nearly three decades of abuse wouldn’t have covered all 366 potential days.
But something about February is always harder than the other months.
Maybe it’s my birthday. The beginning of it all.
I know there are traumas around my birthday, as there are around all holidays and celebrations. I know I was always hurt on or around my birthday. Not only by my parents.
I was date raped on my birthday in senior year of college. And there was an earlier incident…
Yesterday in session, I was flipping through an old journal. I opened the page to February 5th, 2002.
The entry is one sentence long: