Dissociation

I have often used the term 'paralyzation attack' to describe these events where I would just completely retreat into myself, be fully paralyzed including speech and be largely insensitive to pain. I have had these events for over two years, with the severity strongly increasing during the past weeks. Two days ago I learned that it is called dissociation [1]:

"Dissociation is a partial or complete disruption of the normal integration of a person's conscious or psychological functioning. Dissociation can be a response to trauma or drugs and perhaps allows the mind to distance itself from experiences that are too much for the psyche to process at that time."

Everybody experiences dissociation, when daydreaming or just spacing out for a moment [2]. It is when one is exposed to severe stress and trauma that this defense mechanism goes into overdrive to protect your psyche, say during physical and/or sexual abuse, war or other times where survival is called for. In the worst case this can lead to the creation of separate identities, each of which contains the memories of a particular (set of) traumatic event(s).

As summarized by [2], the severity of dissociation goes as follows:

Everyday Dissociation we all experience that is healthy in general
    day dreaming
    spacing out
    fantasy

Traumatic Dissociation that comes from trauma and is not integrated in the psyche
    numbness
    deadened emotions
    leaving one's body

Severe Traumatic Dissociation comes from major trauma that is not integrated in the psyche
    derealization - constant experience of dissociation
    depersonalization - not feeling the sense of "Me" or feeling your body as belonging to yourself
    forming separate identities or self-states
        fully formed identities
        partially formed identities with specific roles
        emotion states that are fragments

Reading through a descriptive list of frequently asked questions like [3] the first thing I noticed is that the description given for depersonalization is exactly like how I described how I saw myself while growing up. The sense of not knowing who this person in the mirror is, not really having one's body as a part of oneself.

Derealization is something I experienced later on when I became disassociated with the world around me, basically after I was forced to move away from the house where I was raised and had spent my entire youth. I lost my sense of smell and much of my sense of hearing back then in addition to having severe issues connecting with the world around me on anything but a purely cold, rational level. This improved for a while, but has taken a turn for the worse again during the last few years.

I have also observed shifts in my personality and behaviour over the past years which are consistent with Dissociative Identity Disorder, as quoted from [3]:

Dissociative Identity Disorder (previously known as Multiple Personality Disorder) is the most severe and chronic manifestation of dissociation, characterized by the presence of two or more distinct identities or personality states that recurrently take control of the individual’s behavior, accompanied by an inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness. It is now recognized that these dissociated states are not fully-formed personalities, but rather represent a fragmented sense of identity. The amnesia typically associated with Dissociative Identity Disorder is asymmetrical, with different identity states remembering different aspects of autobiographical information. There is usually a host personality who identifies with the client’s real name. Typically, the host personality is not aware of the presence of other alters (American Psychiatric Association, 2000; Fine, 1999; Frey, 2001; Kluft, 1999; Kluft, Steinberg & Spitzer, 1988; Maldonado et al., 2002; Spiegel & Carden~a, 1991; Steinberg et al., 1993). The different personalities may serve distinct roles in coping with problem areas. An average of 2 to 4 personalities/alters are present at diagnosis, with an average of 13 to 15 personalities emerging over the course of treatment (Coons, Bowman & Milstein, 1988; Maldonado et al., 2002). Environmental events usually trigger a sudden shifting from one personality to another (Maldonado et al., 2002).


As my emotional state was very much underdeveloped at the time when I was exposed to the Dutch gender teams and associated psychologists - averaging around 8-10 years old in my own estimate - the trauma caused has probably resulted in the development of these identity fragments, and explains the sudden moodswings I can have during a single day, going from carefree, optimistic, talkative about my hobbies and interests to being extremely agitated and angry to gloomy and depressed to outright hysterical and/or suicidal. Each of these fragments and emotional states is associated with particular memories.

I am aware of the presence of these fragments, and I try to avoid them. Their mere presence is however akin to a Sword of Damocles. The occurrence of such strong dissociation as of late that I will pass out on the midst of the street, something which has never happened before, is a clear indication that something has to be done.

The early signs of depersonalization disorder during my youth show that the trauma began there, and is most likely associated with my intersex condition, as the only other thing bothering me at the time was my giftedness, but that didn't interfere too much in my relations with others, as far as I can remember. It was the associating with others where my body played a role, such as with the segregation into the boys and the girls and their associated activities where I became a complete outsider.

This then persisted until early 2005 when I discovered what was most likely the problem with my body. Ideally I would have received proper medical treatment and psychological care and the depersonalization disorder would have faded away. Instead further doubt was cast on what this body I have is about, increasing the severity of the depersonalization disorder, and eventually leading to the development of further dissociative disorders, including Dissociative Identity Disorder (DID).

Solving this tangled mess will involve starting at the part where things went wrong, namely during early 2005, whereby the ideal scenario for that period will have to be followed, together with psychological support to deal with the personality fragments from the DID. At any cost should further worsening of the dissociative disorder be prevented due to self-harm and suicide risks.

Next week I should be assigned a urologist from the local Twenteborg hospital (Almelo). I will be showing that person as well as my GP and the psychiatrist I'll be talking to this article, as from what I understand dissociative disorder is still quite poorly understood by psychologists and medical personnel.


Maya


[1] http://en.wikipedia.org/wiki/Dissociation
[2] http://www.therapist4me.com/Dissociation.htm
[3] http://www.isst-d.org/education/faq-dissociation.htm