Showing posts with label Therapy. Show all posts
Showing posts with label Therapy. Show all posts

Friday, January 25, 2013

Oh, What A Relief It Is: Deep Tissue Massage

After a year and a half we were finally able to get it together enough to find a massage therapist. Luckily the connection came through James' new job. She does house-calls too. And the price is beyond reasonable for the service (deep tissue massage).

While we prefer male masseuses, (it has to do with how deep, large, numerous, and hard the knots are - requiring considerable strength to maneuver), she was able to do some good work to start, and together we created a regiment to alleviate 75% of the pain over a six-to-eight week period. (it's understood it will never be all gone, but at least it can be managed a bit without OTC or prescription pain relievers)

Once again we're back on the table, just in time. It wasn't as bad as it was in winter (January to April) of 2011 yet, but some days and nights it was getting close in the same level of excruciating pain, with the perpetual headaches, tension, knots, head-to-toe body pain, sleepless nights tossing and turning. It only took about 45 minutes to the pain to start creeping back, but at least it was something.

So, there's hope...once again.

We're almost going to feel human again. Almost.

(P.S. still waiting for all the names of the sellers to be inked on the purchase agreement for the house *fingers crossed*)

Thursday, July 12, 2012

Dear Everybody...

We just need some alone time.

As alone as we can get, anyway.

We're fine, we just need to remove some distractions, try to find some focus...breathe.

  • A Beautiful picture:

© 2012. Frank et al. Spring in England.
  • Found today, lived by for over a year.
    The Ten Step program we LIVE by. 
    The 10th Step is BREATH. 
Source...unknown, intercepted on Facebook

  • Just one of our very favourite bands.



Saturday, February 11, 2012

Our Guest Blogger Writes About Personality Disorder

It's guest blogger day!

Today Kerry's entry touches on a subject that we have recently become interested in learning about, due to some association with people diagnosed with the topic at hand.

We've done one blog post so far, discussing Personality Disorders (Personality vs Dissociative Disorders http://just-call-me-frank.blogspot.com/2012/01/personalty-vs-dissociative-disorders.html), illustrating the difference between the disorders as best as we could.

You might also want to read Treating and Healing Dissociative Identity Disorder 
http://just-call-me-frank.blogspot.com/2012/01/treating-and-healing-dissociative.html

We're happy to get Kerry's view on the topic. While we may not agree, or be sold, on the positive side of PD, we completely respect her 
professional and personal view on it; maybe we're jaded from what we know to be a limited (mainly borderline), and negative, experience with people who have these disorders. It's not really our place to have a negative opinion of anybody with a mental illness, if they are working towards getting the help they need. So we're just going to shut our mouth...for now.

We'd like to talk about the range of personality disorders at some point, which have three main classifications:
• Suspicious • Emotional and impulsive• Anxious
   paranoid    borderline  avoidant
   schizoid    histrionic  dependent
   schizotypal    narcissistic  obsessive compulsive
   antisocial
...but today is not the day.

We'd love to have you weigh in on your thoughts and opinions in the comments section following this entry. Just for fun.

And now, guest blogger, writer, mental health nurse, and groovy lady (yep, we said groovy, bite us)...Kerry Stott.
Personality Disorder, what is it and why do I like it?

I work with people who have a diagnosis of Personality Disorder (PD). These people tend to be chaotic in their presentation and resource intensive. By this I mean multiple presentations at A and E (ER for my American friends), possibly police involvement, numerous unplanned admissions to hospital and, generally a stressed out and frazzled mental health worker who co-ordinates their care. These patients can very easily burn out professionals and quite a few on my caseload have had several care co-ordinators prior to coming to me. They are often referred to as heart sink patients, because the mere mention of their name causes professionals to groan. Or at least that is the polite sanitised version.

So 2 questions, what is a personality disorder and why do I like working with people that can burn me out and cause so much stress? Throughout this blog I will repeatedly refer to people who have a diagnosis of PD. This means that they are very much struggling with life and being able to function, and not just a reference to people who are flaky and a pain in the bum. Also, it has a biased towards Borderline/Emotionally Unstable PD as this is the most common group that I work with.

For years I have been trying to find a definitive, snappy answer as to why I enjoy working with PD. Some of my colleagues say that’s because I have one myself, but then so does everyone to a certain degree. I like a challenge and these patients are certainly challenging. However, just because someone likes a challenge, doesn’t mean that they are any good at their job. There may be issues to do with my up bringing that cause me to relate well to people with a diagnosis of PD. Being British I might value the under dog and want to help them. Possibly I may want to ‘rescue’ people. I actually don’t like rescuing patients, I like assisting people to find their own feet and give them the tools to help themselves. Often this means not getting nervous or over anxious/excited if someone says that they want to kill themselves or have taken an overdose. Most of the time it is about being calm and consistent in my demeanour and behaviour towards them, as well as listening and being respectful.

From an emotional perspective I feel that I can connect to people with this diagnosis and it gives me great satisfaction and pleasure seeing them psychologically grow, and being part of that growth process. Watching them become more accepting of themselves and develop a greater independence from their more chaotic behaviour. Working with people who have PD is not about freeing them from it, rather finding some common ground where they can feel more in control of their behaviours and emotions. It’s not all about drugs and medicating people, although medication can play a role. It has a lot to do with interaction with the therapist/care co-ordinator/mental health nurse and the patient, role modelling, therapy, working with each other rather than the professional knowing best. Ultimately it is this team work that I love, the interaction and being able to hear other people’s stories about their lives and to help them see that they have the power and strength to change the ending. It need not be inevitable.

So what is PD? For clarification Frankie does not have PD, she has a dissociative condition, please read ‘D in DID’ for more info.

Personality is what makes us who we are, it make us individuals, separate from each other, psychologically identifiable from each other. I often describe personality as being like facets of a diamond, we all have different sides to our personality: funny, flirty, sarcastic, cruel, mournful and so on. We act and react to each other, usually within the cultural and social norms of our society. We bounce off each other. For example if I wanted to go and have a laugh because I felt funny I would choose a friend who could meet that need. If I wanted to have some sympathy I would go to someone I know who will be likely to give me the response I wanted. It works the other way around too. People frequently come to me because I get things done, or if you want to hear it straight rather than pussy footing around a topic – I’m your woman. However, we work within social conventions too. If I lived in the Middle East I would not be able to do the type of work that I do, wear the clothes I do (jeans and a jumper [sweater] at the moment before you ask), I would not be able to be as outspoken as I am. I live in the UK and I am (at times) actively encouraged to be outspoken, there are forums that promote this such as Facebook and Twitter, as well as my friends and work colleagues.

The key factor is how feelings can dictate our behaviour and they frequently do. As human beings we do things to bring about desired feelings to stop undesirable feelings. I love going on scary rides at the fair ground because I like the feelings that it induces. When I am feeling sad I will often eat crap or drink alcohol. The eating is in connection to trying to replicate the nice feeling that I associate with that food, biscuits (dark chocolate digestives [cookies]) were a treat when I was little and thus when I eat them I still feel like I am treating myself. The drinking alcohol is about dampening down and dulling the emotional pain. As you can see, form these examples how our feelings can force us to behave in a certain way. It is interesting that the two examples of self comforting stemming from different psychological places, as the lay person might think that they were done for the same reason. One way is to dampen down and avoid the uncomfortable feeling, the other to elicit happy memories from my early life. Neither of which work in the long run for clarification, there are most definitely short term coping strategies, but they get me through the moment.

It is these interactions between emotions and behaviours, and social interactions and cultural norms, which help define and mould our personalities. A psychologist once joked that there are no personality disorders on a dessert island. This is true but the one with obsessive compulsive PD will be out there lining up the coconuts and leaves. Livesley (2003) stated that the function of personality is to solve problems or life tasks fundamental to effective adjustment, to develop an adaptive sense of self and to be able to have a capacity to function in close relationships. Thus a personality disorder is the failure to solve basic life tasks. A failure to establish an adaptive self system; unable to develop a capacity to function adaptably in interpersonal and societal relationships. This is about as snappy a definition for PD gets!

In non psychologist speak this means that a person with PD is unable to have the complete range of ‘self’. I work predominantly with Borderline PD aka Emotionally Unstable PD (depending on which diagnostic criteria you use, USA or World Health Organisation) and frequently find people with this type PD are malleable and will be markedly different with different people. Not dissimilar to when I was a girl dating boys and would say, ‘Well he’s lovely when he’s on his own, but horrible when he is with his mates’ but a more extreme and pervasive version. People with a diagnosis of PD will often polarise people, with half loving them or wanting to protect and rescue them and the other half loathing them. Please note that this is not a conscious thing, rather a subconscious strategy that has been successful in keeping them safe through what is an often turbulent childhood. In addition to this what patient’s frequently report is an inability to feel emotionally stable. These emotions are overwhelming, uncontrollable and uncomfortable. I see them dating and falling in love, and falling hard; or feeling sad and suicidal with little in between these two extremes. The vast majority of my time, initially when working with Borderline patients, is being able to weather the storm of this tsunami of emotion. It is this that can cause professionals to become burnt out or cynical. I would place myself in the sceptical category not cynical just yet.

Knowing who you are is essential, how you will react to people and situations. This is the interpersonal and societal relationships that Livesley (2003) talks about. Not being able to maintain personal relationships, and not being able to work out why, is a lonely place to be. It is, therefore, unsurprising that people with a diagnosis of PD tries to get away from it, by any means possible. Thus there is a higher prevalence of drug and alcohol issues as well as self harm and suicidal behaviour.

Being able to work out why people behave and react enables me, and other professionals to offer help and guidance and the appropriate therapy. It really is like trying to work out a jigsaw puzzle. Sometimes (if I am very lucky) I am able to see most of the pieces of the puzzle. However, sometimes I don’t have all the pieces, some may be missing. Occasionally it feels like I only have a few pieces of the puzzle, that they are upside down with no picture to work out where they came from, and that I am in a room with the light off – tough work! Spending time at this point, working out why people do what they do not only enhances the therapeutic relationship because, quite often, these type of patients have not been given the chance to tell the story of their life to a health care professional.

Without a robust therapeutic relationship, nothing will happen and the patients will not get better. Indeed it may make things worse for both the patient and the professional, with increased likelihood of suicide and burnout. It is at this point in the relationship that I will discuss boundaries and rules in which we can work together as a team. What they want from me, what I want from them, what to do if things start to go wrong, who to call and appropriate systems.

‘Appropriate systems’ may seem an odd choice of phrase but it enables patients to have a clear understanding of how to access help and the appropriate way to go about it. For example anyone who is distressed will seek help but if they do not feel that they are being listened to, like a rather snotty receptionist at the doctors, they will try more urgently. It is this behaviour pattern that can cause an unwanted reaction in professionals from the patients’ perspective. This is what I hear a lot of ‘It’s just behaviour’ when I am working with PD. However, that’s the thing, it may be ‘just behaviour’ but it is behaviour at not having their needs met, at not being listened to, at not being able to control their emotional state, at not being able to conform to social norms.

I help people, it’s what I do. Helping people who consistently get themselves in an emotional mess and don’t know how to get out of it is just as valid as helping with any ‘illness’. In a nut shell, that is why I do it and it is why I love working with this client group. I hope that this post (if you ever got to the end of it) gives you some insight into why I do what I do….it has taken 6 months to be able to decant and condense what is a very complex and difficult topic, so thank you for reading.

Kerry x

Livsey, J. (2003). Practical Management of Personality Disorder. New York, Guilford Press.

More guest entries written by Kerry Stott @kerrystott
and visit her websites at http://www.kerrystott.co.uk/

Thursday, January 12, 2012

Treating and Healing Dissociative Identity Disorder


Contrary to popular misconceptions, people with DID/MPD (Dissociative Identity Disorder/Multiple Personality Disorder) are able to perform jobs carrying responsibility, and jobs involving contribution to society in a variety of professional environments, including the arts, and public service. Of all the psychiatric disorders, DID/MPD has the best prognosis of healing. There are, however, people who are institutionalized who cannot cope with, or do not understand, their disorder, but with the right treatment recovery is possible.

What Is DID/MPD?
Rather than reiterate things we have already written, for more information on Dissociative Identity Disorder and Dissociation in this blog (with citations) read:
The D in Dissociationhttp://just-call-me-frank.blogspot.com/2011/08/d-in-did-dissociation.html and also Personality vs. Dissociative Disorders’:
http://just-call-me-frank.blogspot.com/2012/01/personalty-vs-dissociative-disorders.html


[
Or alternatively Google it, but always consider the sources of what you are reading, as with anything on the internet. We like to stick with professional and government agencies overall.]

Dissociative disorders are not caused by chemical imbalances in the brain, as is the case with mood and some personality disorders1. DID/MPD, and other dissociative disorders, are a brains apparent response to chronic trauma or abuse, such as physical, sexual and emotional abuse, in childhood;  and occasionally other traumatic events such as war, natural disasters, kidnapping and torture, as a form of coping and surviving. Not all people who have endured abused and trauma become dissociated. Once the brain has learned to dissociate as a response to abuse and trauma, it can lead to continued dissociation throughout adulthood.

Anxiety and depression may occur with dissociative disorders.

Treating DID:
Treatment for individuals with DID/MPD includes psychotherapy, although various creative therapies (such as art, dance, movement, poetry and drama), and a combination of antidepressants or anti-anxiety medication may be prescribed if needed, in addition to therapeutic treatment that may be related to adjusting how they interact in social environments, as well psychotherapy (also known as talk therapy, counsellingl). Those dealing with dissociative disorders may benefit from psychotherapy to learn methods of coping, and to learn steps to take control of their lives, to be healthy and productive.

While psychotherapy may cause temporary anxiety and stress while a person learns about the condition and the coping skills required to manage positive and negative feeling, moods, thoughts and behaviours, it is a form of treatment that carries very few risks.
  
One particular form of therapy used in Dissociative Identity Disorder is Mapping Therapy (a blog post we did on mapping therapy: http://just-call-me-frank.blogspot.com/2011/12/who-lives-in-your-head-mapping-therapy.html)

Choices of Healing:
Cooperative:
Cooperative healing is a method co-existing where all of the alter personalities become aware of each other through therapeutic means, and the psychological barriers between them are reduced, so that they can work together cooperatively to lead a healthy and productive existence together. Some indication shows that this is becoming a more popular holistic approach to healing.

[For an amazing interview, regarding cooperative healing, with Anne Pratt, Ph.D., a clinical psychologist at the Traumatic Stress Institute who specializes in Dissociative Identity Disorder: http://www.healthyplace.com/abuse/transcripts/didmpd-working-within-the-multiple-system/menu-id-52/]

Integration and Spontaneous Integration
:
Integration is the process, through intensive therapeutic means, of all of the alter personalities coming together. In this process all of the personalities are integrated into one melded, or integrated, personality. The integrated personality is formed with parts, or perhaps none, of all of the alter personalities.
Spontaneous Integration is when integration happens without choice. Just as the brain of the person who experienced trauma knew to separate to protect itself, it may integrate.

In Conclusion:
Dissociation Identity disorder cannot be cured with medication, though some of it's occasional symptoms can be treated with medication. People with Dissociative Identity Disorder are able to keep most of their disorder hidden from society, though often times come off as flaky, forgetful, eccentric and occasionally may appear to be a liar, due to being accused of things they do not recall doing.

People with Dissociative Identity Disorder are able to lead relatively "normal" and "healthy" lives. The ability to hide themselves well from both society and themselves is the primary function of the brain to form dissociated identities, a protective barrier between the core and alter personalities to cope, bear the pain and hide the memories of abuse, and "save" the core, and alternative personalities.

Resources:
1'Personality and psychopathology' By C. Robert Cloninger 1999 p. 312
As well as several other sources cited in our other entries on this blog regarding DID/MPD.

--------------------------
About Our Healing and Treatment:
We have chosen cooperation as the desired route of coping.
Our therapeutic measures have extended a lifetime, always resulting in incorrect diagnoses and over-medication. As it is difficult to both find, and afford, a therapist who we can talk to regarding dissociation, we have chosen more of a self-help route after years of individual psychotherapy involving coping and learning how to manage parts of our life.
In addition, we have managed to work, albeit sometimes dangerously, through much of our mapping, and collective memory retrieval this last year, on our own (we do not recommend this).

 We are sure at some point we can benefit through some talk therapy…but many of us really hate talking, and most of us really love writing, so we have chosen creative therapy to heal, such as music (mostly listening, we are not musically inclined), art and writing. We no longer take medications (a year and a half medication free), nor do we desire to. We prefer to deal with our bouts of depression and anxiety in other ways…sometimes that means not leaving the house for awhile. We’re fine with that.
We hope you have found this entry on Cures and Healing useful.

~Frank et al
-----------------------------
*Dissociative Identity/Multiple Personality Disorder common terminology

Personality Specific Terms
Alteralter states, selves, parts (a subjective term); distinct personalities; fragments alternate personality, personality state, or identity with its own unique perspectives, abilities, memories or other traits that differ from the Host or Executive personality.
The Core: The original birth personality.
Host: is the alter personality who dominates the control of the body most of the time and is often unaware of the other personalities. The host is usually the alter personality who will initiate after experiencing symptoms of mental distress, such as, anxiety, triggers or recovered memories.
Executive: When a personality (alter ego) has control of the body.
Switch: To switch from one personality to another. The process of an alter coming out from the subconscious mind into the consciousness mind while the other alter (who was already in the consciousness mind) slips back into the subconscious mind.
Who's out? A common question used to determine which personality is executive or host.
Co-conscious(ness): A state of being aware of what the other personalities are doing and saying.

Other Common Terms:
Acquired: Anything that is not present at birth but develops some time later. In medicine, the word "acquired" implies "new" or "added." An acquired condition is "new" in the sense that it is not genetic (inherited) and "added" in the sense that was not present at birth.
Triggers: Hysterical conversion symptoms or body memories. Physical phenomenon such as pain, smells, tastes, etc.; re-experienced again.
Dissociation: In psychology and psychiatry, a perceived detachment of the mind from the emotional state or even from the body. Dissociation is characterized by a sense of the world as a dreamlike or unreal place and may be accompanied by poor memory of the specific events, which in severe form is known as dissociative amnesia.
Re-live: A total memory recall (includes visual, emotional, physical and all other senses).
Losing time: Also known as a Dissociative Fugue, is the period of which an alter personality is in the subconscious mind and has no recollection of the time that is being utilized by the alter personality who is occupying the conscious mind. Therefore when the alter switches into the conscious mind they realize that minutes, hours, days, or even months and years have passed since they were last aware of time.
System: is the structure of relationships between the alter personalities who live within the internal world of a survivor with D.I.D. Every system is created and operates in it's own unique way, just like every family living in their own homes run their households different from the next door neighbour.
Inner (Self) Helper: is usually the alter personality who has a good understanding of the system and how it works. The I.S.H. is also among the typical group of helpers or protector personalities.
Grounding: is the process of disrupting a dissociative episode and is accomplished by tugging on an earlobe, rubbing the hands together, or shuffling the feet back and forth. This type of physical stimuli can bring the survivors mind back to awareness of their surroundings, and helps to make them feel less animated.


Wednesday, January 4, 2012

Overcoming To Get To Your "O"

This is an adult subject...so pretend you're over the age of 18...
Being in the presence of any health professional is a bit of a crap shoot for us, some of us are very careful about what we share, some of us just babble about everything and tend to be overly open about our life.

Today was an “open” day for us, partly because the practitioner was friendly and had a good sense of humour. Good bed side manor" can go a long way with people who struggle with mental health issues.

Despite the fact we saw a gynaecologist there was an unusual amount of questions on the form we filled out (compared to what we can recall about the last time we were at that clinic)…among them questions about any past abuse of the mental, physical, emotional kind.

Of course we disclosed the truth, asking first "You mean, ever?", making sure to state that it had been a long time ago, mostly during childhood. She asked about counselling and charges, and again we disclosed it all, that it had been taken care of a long time ago (we’re 32 now). This after the brief discussion about our past diagnoses of major depression, bipolar disorder, and schizophrenia, (we are weary to tell any stranger in person about our DID/MPD, for very obvious reasons...we don't like straight jackets, for one); so she knew we had plenty of counselling but was sure to give us a card for a local, and free, community action program against violence where people can go to discuss abuse, even this far in the future, in a confidential and safe place, with professionals. This was pretty heavy for a fucking gynecological appointment.

Anyway.

The reason we are mentioning this at all is more about our readers (many of whom struggle with mental health issues), or perhaps you, and people having problems forming healthy long lasting relationships. It was something she said to us that we come to the conclusion about years ago (not that it's helped us with long lasting relationships, but that's not due to one-sided issues), and has helped is the last couple of years.

She said that no matter how long ago someone’s abuse was, or even if they can remember it all, if they were 2, 16 or 21, any age, or even if they can only remember parts of abuse, is that a history of any kind of abuse affects how people form relationships, if they can handle them with success, form healthy and sustainable ones. She also mentioned that it can be a big barrier for women who are not able to orgasm. Research shows10-15% of the female population* have never made their "O" face (for real, we're not taking faking it here).

While we are not a giant fan of medication for mood and depressive disorders (because there are other ways to deal/manage with them), we are an advocate for therapy (counselling), because sometimes people need to talk to someone that they can trust in order to overcome issues and work toward a happier, more functional relationship...and orgasm achievement. 

It’s no secret that an abusive past can affect the way people form and grow relationships**, and draw satisfaction from them, and "research shows that 90 percent of the problems women have in achieving orgasm stem from a psychological nature*."

So, what does an orgasm have to do with a healthy relationship and vice versa? Everything to a survivor of abuse. The more secure you are in a relationship the easier it can be to reach orgasm, and sometimes that simply comes with facing abuse from the past, learning to overcome it and manage your feelings, and moving on to a healthier psychological future...things that medication can not help (often times medications cause adverse sexual side-effect, to add to the problems already existing).

This entry today is for the benefit of women who come from abusive backgrounds, and our hope that they take all the steps necessary to love themselves, even if it means therapy/counseling, to overcome abuse and bad relationship patterns, to form sustainable fulfilling relationships...and attain earth shattering orgasms.


~Et al


If you need someone to talk to about mental, physical or emotional abuse, whether it be past or present, Google your local violence and/or abuse prevention centers to find help near you.


Sources:
*Health - The Female Orgasm http://www.drphil.com/articles/article/371 (yeah, it's Dr. Phil...that doesn't mean it's not legitimate information)
**Long-term Effects of Child Sexual Abuse by Paul E. Mullen & Jillian Fleming http://www.aaets.org/article176.htm


- Cupids Poison Arrow: Biology Has Plans For Your Love Life http://www.psychologytoday.com/blog/cupids-poisoned-arrow/200908/orgasm-s-hidden-cycle
More on female orgasm:
- Red Ribbon Project: Female Orgasms http://www.redribbonproject.com/sexual-health/womens/female-orgasm.html