BPDRecovery.com: Forums

It has been two weeks since I saw my therapist. I am spacing out my appointments since I only have 20 covered by insurance a year and they will not get me through 52 weeks in a year. I will be taking the summer off (for summer employment) so that will further stretch out my appointments and I suggested that after the summer we go to once a month appointments. My therapist said that she will agree to see me every other week but she does not want to go longer than that between my appointments. Today she asked me to write her a letter after the summer is over requesting a "reduced fee" so that we can meet weekly because she says she is not comfortable stretching out the remaining appointments through the end of the year. Apparently she can not just offer me a reduced fee because then she would have to do that for all of her clients, according to insurance policies, but if I were to request a reduced fee in writing and state financial hardship as the reason then she can reduce my fee to what Medicare will cover and she does not have to do that for all her clients. She told me this in the context of wanting to help me and being willing to give her time to do that (she would only be getting paid half of her fee this way).

When I was in therapy with my former therapist, she worked for an agency and there was some sort of "grant" money that she applied for in order to cover my therapy when I could not afford it. At the time my former therapist took me as a new client, she was the assistant director and she was not taking new clients, just finishing therapy with the clients she had half-time. Since she was working for an agency, she was not giving up her salary to help me. My current therapist is basically asking me to request that she give up a portion of her income in order to see me. I told her that I would rather use a lack of money as an excuse to get out of therapy but she insisted that she wanted me to get back to a weekly schedule once the summer is over.

I am really torn about this. On one hand I appreciate that my therapist thinks she can help me and she does not want money to be a barrier to my doing therapy with her. On the other hand, she should not be penalizing herself by taking a pay cut to work with me on a weekly basis when I have stated that I am okay with meeting less frequently. When my former therapist took me as a client (while she was not taking new clients at that time) and told me that she thought I was the "most needy" client she had ever seen, I was a bit offended by her statement (when I spoke to her about it later she said that what she had said was that I "most needed therapy" as opposed to being the "most needy" so I may have misinterpreted her words in a more offensive way than she intended them). I think that I am hearing this same message from my current therapist, that I am somehow "needy" and I find it offensive to think that I could be any more "needy" than her other clients.

I should just be grateful that she is convinced enough that she can help me that she is willing to take a pay cut and I should therefore be willing to accept the help she has to offer me. So, I don't know why I am "looking a gift horse in the mouth" and finding reason to be offended. I think that the idea that I "need help" is one I struggle with.

I am still working on "acceptance" about my diagnosis. I told my therapist today that I would prefer to think of DID in the context my former therapist worked with me on it - as a "severe form of BPD" as opposed to the whole MPD thing. I also told her that I had not completely "ruled out" spirit attachment as a possible explanation of my symptoms and that I would prefer a "quick fix" over "talk therapy" because I don't want to spend years talking about the past when I need to fix the problem in the present. She again told me that she thinks I have DID and I really did not want to hear it (again)! When I told her that I don't want to have DID because I don't want to be a freak, she wrote on a sticky note that I am not crazy, that I use dissociation to survive difficult experiences, and that I can learn to cope in more sophisticated ways. She wants me to remember these three things but I am not going to keep the stupid sticky note in order to review them over and over again (I already threw it away).

I don't know why I keep thinking I need to die. It just keeps sounding like the best solution to the problem, even though I am not suicidal right now. I keep trying to reach a place of "acceptance" that I have DID and yet at the same time I won't accept it because I don't want to have to deal with it. In order to avoid dealing with having DID, dying seems to be the answer. I feel really stupid about my resistance because I can't just deny something and make it go away if it is the truth. I am trying to think that I can live with DID but so far I can get the words out while I don't know if the words are true for me. I feel like I can only live with it if I can make it go away and that is not the same as living with it. I am supposed to accept it as truth and work on changing it through therapy. That sounds easy enough so why can't I just believe it?

What I am trying to communicate here is that I hear my therapist saying that I have this problem but that she can help me with it while at the same time I have to be willing to accept the problem and meet with her weekly to work on ways to solve the problem. That sounds logical. At the same time, I seem unable to get to that starting place because I want to rewrite my own reality to something I am more comfortable dealing with instead of dealing with the actual problem as it exists in the here and now. Somehow after all these years of working on "acceptance" I am still working on acceptance.

How the heck do I get unstuck from this "tar baby" that I have been fighting for so long? If I stop fighting, I am still stuck but if I keep fighting I get even more and more stuck. I am trying to stop fighting against the DID diagnosis by accepting it and yet acceptance that I have DID leads me to thinking that I must die. I try to be willing to live with the diagnosis and at the same time I don't feel like I can live with the diagnosis because I don't want to live this way. I don't think I am depressed and I am not actively suicidal so these thoughts of dying seem "out of character" for me right now. I just want the thoughts out of my head so I don't think them anymore.

Hey, Denim ~
If agreeing/accepting that you have DID is too big of a leap for you right now - or you're not convinced, or it is too scary or overwhelming - how would it sit with you if you accepted that this professional you trust [to whatever extent] believes she can assist you in dealing with and overcoming those problematic symptoms that *she* refers to as DID?

Perhaps look at regular therapy as a science experiment... a study where you are either/neither in the study group or the control group... where the benefits are a two-way street - you find out more about these problematic symptoms that affect you and the therapist learns better how to treat these problematic symptoms. That's kind of what would be going on anyway, right? [fwiw, this latter perspective helped me when I felt 'needy' or 'less than' when I was actually in a mental health study...]

I don't think you need to accept a clinical label - especially if it conjures up dying as the only other alternative. How 'bout you accept that you do dissociate, it developed as a survival mechanism, it is problematic, and can be treated.

~ jr

Denim,

I have noticed that you prefer that special accommodations not be made for you. I can see that this therapist offering to reduce her fee for you touches directly on that.

Tell me if I'm wrong, but another thing I see is a sense of foreboding in you about doing work around DID -- it could take a long time, it could take you places you're not sure you want to go, it could simply not help. I see that you would like to either get better quickly or just forget the whole thing and keep on as you are.

One thing I've learned as I've addressed my own issues is that things always get worse before they get better. Do you think you can become willing to go through difficulty on the road to getting better?

Peace,
jim

I don't want to say the wrong thing, so I hope this comes across as helpful. I think if you trust this T and go to therapy regularly, you can get to the crux of your difficulties and overcome them.



I think your T is saying that you must talk about the past in order to fix the problems in the present. Sometimes a "quick fix" is not the answer. I totally agree with your T that you are not a freak, that you are not crazy. You are an amazing woman with the capacity to do much good in the world. The DID label just means to me, like your T says, that you have found a coping mechanism that works for you. But it doesn't always work, does it?

You have a chance to really heal with this T. You aren't needy, but you need therapy. That's a big difference. You're capable of many wonderful things, and not needy, but in order to fix what's wrong, you have to deal with your past. I think I can imagine why you would rather die than go there. It's uncharted territory for you, and will be scary. But you won't be doing it alone. Your T sounds like someone who will understand how difficult it is for you, and will take it slowly. You've also got this board for support.



It's VERY logical. You're a highly intelligent person and your reasonable, rational mind accepts and knows the way to proceed. But I know very well what the emotional mind can do. It can sabotage the whole effort! Do you think you can listen to your rational mind and go for it? I want that so much for you, Denim. To take one step at a time, trust this T, and move forward even though you are afraid. I think there's a book called "Feel the fear, and do it anyway!" I know you don't want to die; you're just afraid, and that's SO understandable. To reiterate, you're NOT crazy and you're NOT a freak. You've just got challenges, like every one of us has. With hard work and determination, you can overcome them.

The way I see it, it's by accepting that you have DID, and that there's no quick fix, that you can, in the long term, make it go away. There's no quick fix. You can't make it go away in any short term, quick sort of way.

It's the difference between accepting that you have it now, and accepting that you will always have it. You don't have to accept that you will always have it. There's no reason to. But accepting that you have it now is the first step in the journey of getting to that place where you don't have it anymore.

Denim, I can empathize with you. When my T first told me I had BPD, I didn't believe him. I argued with him. I told him it wasn't possible. It took me MONTHS to accept the diagnosis. I wasn't thinking suicide - it just didn't seem possible to me.

However, no matter what your diagnosis is, you still have the problems. No matter what you call them, you still need to deal with the issues and how to live healthily and safely.

I personally would take the T up on her offer. She must think she can help you if she would agree to a pay cut. That said, she also seems committed to helping you and wants the best for you. I would definitely go for it. She's offering you a gift and I wouldn't turn it down. I'd accept it and try to work as hard as I could.

I can understand how you feel about the diagnosis. It must be scary for you. But as I said, you still have the symptoms and they need to be dealt with. Can you work on those symptoms, even if you don't put a name to a diagnosis? Can you write down what exactly is so scary to you about the diagnosis of DID? What does it mean to you? How does it make you feel?

Having a diagnosis of BPD or DID is not a judgment about who you are. It's an illness, just like having diabetes or arthritis. Of course I know it's a bit different, but it doesn't mean you have character flaws or anything. It's just the way you learned to cope with things. It doesn't say anything about who you are as a person deep down.

I hope you will consider her offer and help yourself. It's not often that something like this comes along!

(((DenimBlue))) Know you're not a huggy person, but I am One thing that springs to mind is therapy can be conducted without the need for labelling. You & your T can focus on symptoms, not labels. I don't see why you need to accept the DID label, because the whole point of therapy is that one day you won't have this label anyway. Besides with the kind of treatment needed for the post-traumatic and dissociative disorders, building up trust and establishing safety should be the main focus of treatment to begin with, not upsetting a client with labels. I know that I spent a good 18 months or longer in this stabilisation period.

I so wish you could get past seeing the DID label as being a "freak." You're just a wounded person as far as I can see, but a very lovely wounded person. I remember way back when you & I first knew each other and I remember you using the "freak" label with me when I spoke up about "parts of self." I remember how much it hurt me to be called that (I took it personally) and I wonder how much damage you are doing to yourself using the same label.

DenimBlue - I had a severe dissociative disorder myself, with the whole needyness, fragmentation, dissociation thing going on and I sure know how frightening it is to face all of that, but here I am a few years later and I am doing a whole load better. I have pretty much integrated most of the parts of self, except for one that we just started working on this week. Do you read my words and think "Amanda is a freak." I mean DID is only one step further along the continuum from Complex PTSD - Both involve fragmentation of the emotional part of the personality.

Acceptance work, requires accepting things as they are, without judgement, without labeling. It doesn't mean you have to like it, but you accept that it just is.

Just as a thought, my T charges me a lower hourly rate than her short-term clients. One of the reasons I suspect that she did this is she knew that treatment with me would be long-term thing and that she would make enough money from me over the x amount of years that I would need treatment.

I have had a hard time coming back to this thread. I appreciate all the replies, it is just taking me some time to digest each one.

I have taken this perspective quite a bit out of a reluctance to put a label on my symptoms. I think of the blind mice describing an elephant so that their descriptions for the same thing are so different based on what part they are looking, depending on what angle they are approaching the elephant. The main reason I have stuck with therapy is out of a resistance to put a label on my symptoms because in the past as soon as my dissociation is brought up, I don't want to talk about anything anymore. Even while hospitalized I have indicated that I will only discuss certain things (discharge) while I refuse to speak about other things at all. It is my choice what I talk about and I can limit a discussion to those things I am okay discussing in therapy. Although I am not sure I believe that this therapist will be able to help me, I can trust that she will allow me to change the subject or limit what I am willing to talk about so that I can tolerate therapy better.

I think that is where I am at in a nutshell. As long as I can keep my value judgments about myself out of the picture, I can accept these things.

I am that transparent, eh?! LOL I have a hard time with the willingness for things to get worse in order to get better. It is like trying to schedule major surgery and knowing that there is going to be a higher cost before any benefit is obtained. I tend to prefer to "wait it out" rather than to decide that now is the time to do what may eventually need to be done. My hope is that I will die first and it will then be unnecessary to even consider therapy.

Things are really messed up right now and I thought I could handle it but it turns out that the "out of control" feeling is overwhelming enough for me to want to "check out" completely. I feel "exposed" having people know about my mental condition. It is very hard to talk about such personal things so that I can get help. My instinct is to hide the problem and hope that no one can see that there is a problem.

The most interesting thing is that I can be so high functioning that people would never suspect I am mental in any way and yet I can also come completely unglued so that I appear as if I am totally incompetent. Taking away the glue that holds me together will leave me in fragments and that scares me more than anything. I want to keep filling the cracks as they become visible rather than to try to rebuild my self again. I am also terribly afraid of looking at the past, even though I know logically that it can't kill me (it obviously has not done me in yet). I don't want to see what is lurking there because of what I already know is in my past. I don't want to even think about it so that talking about it becomes mental torture for me. I want to let it go and not have to deal with it anymore.

I do have the ability to think and reason in very logical ways and I know that there are things I must do because they must be done. At the same time I don't want to do those things and so I am doing what I can to avoid doing what I need to do. My former therapist said that I tend to do things to avoid negative consequences rather than to do things for positive consequences and she was right about this. It is hard for me to decide to do something that has negative consequences in order to eventually have positive consequences because my tendency is to avoid the negative consequences and never get to the positive consequences that way. Being on one side of Hell and looking across at Heaven, I am content to stay where I am so it takes being in the middle of Hell for me to be willing to go through Hell to get to Heaven. I am successful enough at avoiding the flaming inferno that I am stuck at the edge getting burned but not completely consumed by the flames in the crucible.

I seem to want the "quick fix" or else I don't want anything to do with the journey! I think of my daughter's friend who is going through chemo therapy in order to kill the cancer in her body. The treatment makes her sick in many ways and yet if she does not go through it her body will die. I tend to think of DID as the "cancer of mental illness" because it is such a long painful course of treatment. It would be so much easier to just let it kill me. I have wished for cancer to kill me so it is no wonder I am just waiting to die so I don't have to deal with this stuff. I don't know what is is about life that makes people want to live.

I know that I am fortunate that my therapist does not see me as a "hopeless case" when I tend to see myself that way. I have next week off from therapy and then the following week we are going to have a conference call with my former therapist so my current therapist will have a chance to talk to her in a way that I will know what is being said about me. At that time I will need to decide if I want to go through with the recommended course of treatment.


I think my therapist has been trying to establish trust with me since I began seeing her. She has also held off on pushing the issue with me because she knows that I am likely to flee from therapy (I have already "quit" a couple of times, LOL). When she brought up the whole "parts" thing I told her that I wanted her to tell me that I don't have DID and she said that she could not do that. I have denied her access to any of my mental health records because I did not want her using them against me and yet she has come to the same conclusion that so many others have before her. I am at the point where it is not working to deny the problem anymore. I am going through some unconventional therapy with another woman and she talked to me about my having different "parts" as well. She works for the Department of Social and Health Services in a Child Study and Treatment Center but the work she is doing with me is outside of her regular employment at no cost to me. She has experience working with abused women in this context and has been successful so I am hoping this help supplement the "talk therapy" somewhat and speed up the process.

I don't recall ever thinking of you as a "freak" but I may have referred to myself that way on a number of occasions. I regret having hurt your feelings that way and I am glad that we can still be friends regardless of some disagreements we had in the past about the whole "parts" thing. I may have made invalidating statements to you as a means of denial of my own issues and I hope you can forgive me for my insensitivity to what you were going through at that time. It is likely that I have damaged myself with such invalidating statements as well.

I initially told my therapist that I have issues related to PTSD because I was hoping she would use PTSD as the diagnostic label for billing and not mention anything about a dissociative disorder in my chart. In the USA there is technically no such thing as Complex PTSD (it is not listed anywhere in the DSM) so that is only a label used in other countries. What I have been diagnosed with in the past is "chronic" PTSD, meaning that the symptoms are ongoing as opposed to transitional following a single traumatic event. I know that dissociation is on a continuum with DID being the most severe as my former therapist said that DID was a "severe" form of BPD and Chronic PTSD was a suggested label for people who have symptoms of BPD as a result of trauma rather than as a disordered personality. I don't think you are a freak because you have dissociated emotional parts. It is the MPD type of dissociation that freaks me out about DID (DID used to be called MPD). The treatment for DID tends to be too long-term but perhaps I could get through it faster. My therapist keeps cautioning me to "take it slow" and to "take care" of myself but maybe I could go at a faster pace than what she thinks I should do in order to get it over with faster. I think she is afraid that I will become suicidal if we go too fast.

I am trying to do the acceptance thing without thinking too far ahead of that initial step. I keep thinking I am there, but then I have not been able to move on because I end up dealing with acceptance again every time DID is mentioned in therapy. I think it is my judgement about my own behaviors related to DID that keeps me stuck because I still have the "freak" mentality no matter how many times I think I am ready to move on.

Wow, Denim, what a lot of time and thought you put into your reply. It looks to me that you see your choices pretty clearly right now. Do you feel that way? I don't blame you for being reluctant and resistant. It will take a lot of courage to choose to do this work, and a lot of courage to see it through, as you will have to slowly let go of things that have held you together and then build new, better ways. I sense that the letting go part frightens the bejabbers out of you. But I also sense that you are much stronger than perhaps you realize. I hope you will choose to do the work, of course, because I believe that you will not regret it when you come out the other side. But if you are not yet ready I will still be happy to see you here.

Peace,
jim

So now I have bejabbers, too! LOL

Other people tend to have more confidence in me than I have in myself. Then again, I tend to be able to do things I never thought I could do so perhaps they are right. As much as I keep wanting to quit therapy, I am still plugging along because people keep telling me I should and they encourage me to keep going. My own thoughts tell me differently, which is why I look for feedback from others outside of my head.

Denim,

I'm glad to hear you are going to therapy, especially considering how you feel about it. Everybody is so different within diagnoses that the amount of time in therapy, the treatment, everything is going to be different depending on the person. The label is only there for generaly diagnostic purposes and to help the clinician have a sort of road map on how to treat us.

Truly, I'm getting to the place where I am less worried about my labels or diagnoses and just want to feel better. I have and still do have issues with acceptance of my labels. I sort of put the acceptance on hold and because I do know I have problems in living I go forward with the recommended treatment. Do we really need to fully accept the diagnoses in order to be treated?

Your a stronger woman than you make yourself out to be. I see you wanting to run from treatment, especially during your summer job (although I'm assuming it will take you too far away to attend sessions?). I can see that if you and your therapist get into some difficult topics it could be very painful, very uncomfortable especially talking about stuff for that one hour and then going home and having it linger while you wait for the next session. I've experienced it, but does get easier. You know you can tell the therapist if something is too painful to talk about, or whatever---you can tell her what your needs are and you can do it over and over.

I also notice you refer to getting treatment over with, as if you can speed up the process or go through the treatment as if it is walking up to a door and then ending up on the other side. I don't really see it that way anymore. I think we can get better and better and we will look as if we are "normal" (not that there really are any normal people out there). We might learn to function in healthier ways and be able to give up some unhealthy behavior. But we will still be "us." We will probably still deal with our issues to some smaller degree. Maybe you can look at therapy/treatment in a new way, redefine it. Make it yours, your reality. Is your therapist only interested in talking about the past? Or is she talking about today also?

Anyway, I do hope you don't run this time. I hope you will tame that fear and just do it anyway.