One of a series of posts about life pre and post diagnosis -the early years.

Diagnosis part 1

By the time I was told that the professionals treating me thought I had a dissociative disorder I had spent years in the psychiatric system. I had been misdiagnosed and treated in some awful situations and I was taking a multitude of medication. Medication that didn’t seem to make any changes to the symptoms I appeared to have. I had come to learn that psychiatrists liked to prescribe medication on top of medication and especially when you are a patient in hospital.

I knew I was losing time, I felt like I existed in a state of confusion and chaos and I thought people were lying to me. They said I had done things I knew I hadn’t and would tell me things I had supposedly said which I knew I hadn’t, except I now realise a part of me most probably did.

It was 2008 and I was stuck in a secure psychiatric facility, I was detained on a Mental Health Act section 3, in fact I’d been in hospital non stop for over 16months. I really had no idea what or who I was anymore and I didn’t realise that Dissociative Disorders existed.

The psychological team treating me had done a number of test on me already, these included a DES II form, that’s the Dissociative experiences Scale version 2, the Multidimensional Inventory of Dissociation (MID)and a couple of others tests that highlighted dissociative markers. Apparently; though I didn’t know at the time, they had seen me switching from one alter to another and back again.

The dissociative experiences scale is a questionnaire which I had to complete, and it’s a useful screening tool for DID but is not a diagnostic test. It includes a subset of items which can be used to assess depersonalization and derealization. (Kennedy et al (2013)) It gives professionals an indication of those people who are potentially more likely to dissociate.

The MID was designed to diagnose all dissociative disorders by comprehensively assessing the entire domain of dissociative phenomena, including PTSD, severe borderline personality disorder and all dissociative disorders (Chu (2011)).

My psychiatrist at the time didn’t believe in dissociative disorders and so she denied their initial request for a more formal assessment. But I was fighting to be removed from my section and was due to have my section renewed in just a couple of months time. I had already been told by the private facility treating me that my section was going to be renewed, no matter what happened or how I was presenting medically at the time.

I mentioned in passing to my solicitor (legal representative) that there was a disagreement between the psychologists and psychiatrist treating me. I mentioned that the psychologist had suggested I might have a dissociative disorder and I soon realised he like me had no idea what a dissociative disorder was. He had already decided I need to be assessed by a forensic psychologist ahead of my tribunal and the potential renewal of my Section 3.

So he arranged for a doctor to come and assess me fully and at the same time to check if I had a dissociative disorder. I told him I wouldn’t believe any new diagnosis because I had so many and I didn’t feel they meant anything. So eventually it was agreed I would see two different professionals who would assess me independently of one another.

These assessments took place over a month and as I couldn’t just walk out of the hospital and go and see these people, the professionals came to me. The assessments involved a multitude of tests and appointments, the forensic psychologist decided to visit me for what was 2 full days. He undertook every psychometric test that I think exists. It went on and on and I felt exhausted physically and emotionally after his visits.

There were tests involving papers to complete, multitudes of verbal questions and even picture of dots and shapes to describe. This doctor was actually quite assertive, so he wanted answers instantly it felt and I learnt later that he asked some questions more than once. I had no idea at the time this had happened and so was surprised when I found out at a later date. He duly made notes of everything and seemed to never need a break and he watched me like a hawk the whole time. He undertook tests on my memory and my recall and it felt like I was in a experiment lab being analysed from the inside out.

One of the tests he undertook was the Structured Clinical Interview for DSM-IV Dissociative Disorder (SCID-D) test which involved a multitude of questions, he duly marked down my answers and the results of his observations of me. The SCID-D is a highly structured interview that discriminates among various DSM diagnoses. The test was formulated by Dr. M. Steinberg and it’s regarded as one of the key tests for Dissociative Disorders.

The second professional I saw was a specialist in Dissociative Disorders he used the DES-II and the SCID-D. His appointments were less formalised and more relaxed and he had spoken to me on the phone ahead of coming to see me.

Both were professionals in their field and highly skilled and both compiled lengthy reports about me which I still hold onto to this day. The results of all these tests were that I definitely had Dissociative Identity Disorder, I wasn’t mad, I wasn’t dangerous, in fact I needed to leave the confines of the secure unit and live in the community. They also recommended that I needed long term talking therapy from someone skilled in treating people with dissociative disorders. Both had realised that I had become partially institutionalised by the long term hospitalisation that had been forced upon me and that needed to be addressed as well and they gave recommendations about that.

The two reports do differ in part as the forensic psychologist contains more detail on certain matters that a Mental Health Act Tribunal would need. Yet they both independent of one another after days of tests agreed on my diagnosis, a diagnosis that I found scary, bewildering and confusing in it’s own right.

To be continued……

Copyright DID Dispatches 2014

References:

Chu, James A. (2011). Rebuilding shattered lives: Treating complex PTSD and dissociative disorders, appendix 3. Wiley.

Kennedy, Fiona, Helen Kennerley, and David Pearson, eds. (2013). Cognitive Behavioural Approaches to the Understanding and Treatment of Dissociation. Routledge.