The sound of little boxes on the hillsides
Since I took the dissociation course with Nijenhuis the last year, one message has been firmly learnt. “NEVER think that you know or understand more than the person in front of you”. Trauma-patients are especially vulnerable when it comes to suggestions, and often try to please others by becoming who you want them to be. For this reason, I had to look at myself in the mirror again and again, while remembering that I can`t see or understand what`s behind it more than anyone else. By letting go of my need to understand, to interpret, I`ve understood more (or so I think). By accepting what is, I`ve seen my clients reality more clearly, but I have to keep cleaning the cool surface of the mirror when necessary. What scares me, though, is how easily everyone forgets to do just this. We can walk in dirt until it drowns us, until it pokes us in the face. When the dirt has infected everything, we finally start to clean up. Almost like using a dirty rag to clean up the mess. I´ve heard stories of abuse and neglect, of babies with their diapers so full of shit, that it falls to their knees. That is horrible enough, but I wonder: Is it not worse that grown-ups never change their diapers? Shouldn`t they have learnt that? What kept them from noticing how bad it got?
Our society has a both good and bad sides. The world will probably never reach a perfect balance, but we must still strive for it. How can we heal and preserve? For many therapists, diagnosis helps to find a direction for the right treatment and possibilities. I won`t rant against the system of classification for too long, but I just want to make one point: Who likes to be put in a box? Who likes to be told who they are, from people they barely know? Who likes to get their lives transferred to a DMS-IV classification that lead to life-altering consequences, with the justification of “this is how we do it” attached to it?
I sure don`t. What about you?
6 thoughts on “The sound of little boxes on the hillsides”
September 4, 2014 at 06:45
Well said, Nina
As you say, diagnosis can be helpful in order that we access the right support and our diagnosis has been very helpful in that way. However, just because we live *within* D.I.D, we are not the same as every other person who shares our diagnosis…we are just us.Each person is unique, as are each part of a person who is multiple and while severe enduring trauma is the root of D.I.D, there are marked differences in how D.I.D “presents” depending on the particulars of the traumas, and the particulars of the parts which make the person.
Have I made sense? Hope so.
September 4, 2014 at 16:41
Reblogged this on Liam Uber's Blog and commented:
The observation that we are individuals and should be respected as such is so true, yet it is almost universally ignored. It is easier to deal with a diagnosis, a stereotype of a cartoon. It is more efficient and more cost-effective, but it isn’t right. The patient is short-changed and we learn how to accept mediocrity.
September 5, 2014 at 07:38
Nina, this is a popular view you have articulated, but there are profound problems with it. Our situation as professionals is not improved by giving in to populist views which are inherently erroneous.
Does anyone object to being diagnosed with a particular cancer? What’s the alternative? Some kind of vaguely comforting care which, in the end, will kill you? If its ovarian cancer there are thing we do which we do not do if it’s brain cancer, or an ulcer. And those diagnoses exist because they reflect real patterns in the observable world.
Diagnoses are not arrived at carelessly. They are groups people naturally fall into, and they are very helpful. The idea that having diagnosis somehow constrains you makes no sense relative to physical disease, why does anyone think it makes sense with mental disease? It doesn’t. If you have a small number of characteristics, I know you have DID. Knowing that, there is much that I can know about you without having to ask, because has some well known common characteristics.
In psychotherapy, one’s individuality is important, but so is one’s commonness. I DO know more about DID than any DID client of mine, because I’ve studied it, I have background to put what I read into context, and I have considerable clinical experience with multiple individuals. My single DID client has none of this. I’m supposed to believe that a single person with DID sitting in front of me knows more about DID than I do? Are you serious? You can’t be. That’s just absurd. And if Nijenhuis really believed this, he would be unable to write book or articles, because they are always expressing generalizations about entire groups of people.
People with DID surely DO know more about their experience than I do, or at least parts of them do. It would be helpful if the parts could pool that information and share it with me in the way that someone with depression can. But they can’t do that. They have DID, remember? AND they have no idea what to do about that. Now, THAT’s real knowledge!
However, I do have good ideas about what to about it. That’s why they come to me. I know more about DID than they do.
Enough with this nonsense!
September 5, 2014 at 08:38
I think we misunderstand each other. I always give the diagnosis necessary to give right help, should it be medication, ect or some tailormade treatment. I just meant to say that we need to listen more to our patient, not give a diagnosis before we know for sure and Take what they tell us seriously !
September 5, 2014 at 08:47
Well, with that I do completely agree!
Preparing to retire for the day, I was going over my thoughts on this matter. I’m comfortable with all that I wrote, and at the same time, I am particularly conscious that the bottom line, for our work, is that our client feel better. That sounds simple, but it often isn’t, and to understand why that is, and to craft a proposed solution that best fits an individual, we have to undertake an intense collaboration. I can never know enough to accomplish that object all by myself. To the contrary, they must tell my, by their ongoing feedback and self-report, where next to direct my energies. I just cannot do that alone.
That sounds a lot like what you’re saying immediately above, I think.
January 15, 2015 at 07:43
I think we misunderstand each other. Off course we have to find the right diagnosis, to give the help that the patient needs, what I meant is just that we must not forget that people are so much more then their diagnosis.