Elysium’s Therapy Frustrations Part 1

Elysium3000 left a comment elsewhere on the blog about her frustrations getting a diagnosis, therapist’s opinions/beliefs about dissociative disorders, and the fear of being outed. Since her fears are so common and I’ve written on some of this before, let’s try and work through these issues again. Since my feelings and subsequent research got a little long, I’m splitting this into a few posts.

She writes:

I’m so frustrated right now. My therapist keeps saying stuff like this is just BPD and I don’t think she believes the PsyD assessment and dx. She is asking me to get a second opinion because she states I am “owning” the dx so much and she is worried about Iatrogenisis. I have agreed to get a second opinion if only to get everyone on the same page.

I am at the point that I truly believe I fall in either the DID or DDNOS are of the dissociative continuum but honestly, I don’t care what label you smack on it, I am still having the experiences I am having and I wish my therapist would look into this with an open mind instead of with suspicion.

My Psych Nurse Practitioner who manages my meds is stating that she is going to call the State Board (I am in the medical profession) and anonymously ask them if she needs to DISCLOSE my dx. I am freaking out!! She states that she doesn’t “have a clue” about dissociative disorders, so she’s going to call other people who have even less of a clue and then there is going to be a big issue made when there doesn’t need to be. VERY ANGRY…SCARED…FRUSTRATED. Thanks…but I really don’t want to be OUTED!!

I’m going to reply to your concerns in a couple ways – just like I will ask you to address your fears and frustrations about all this. First, from the emotional perspective – understanding that your feelings and this internal conflict is normal even though they are all over the board! And second, to pause. To break it down to see how we take steps forward to address these frustrations and fears.

Perhaps a small consolation, but you’re Normal

Let’s talk here about the emotional impact – your frustrations and fears. Everything you are feeling is “normal” – your thought process and concerns are valid – even feelings about your therapist and the nurse practitioner. (If you are like me, part of you will believe this as fact, and another part will rebel that you are somehow crazy. This is normal too.)

But first, who am *I* to say you are normal? I’m just one person. But you’re commenting on a blog read by lots of other folks who are/have been in exactly the same situation. And there are lots of other blogs and people. You’re not alone.

We all would let you know your pain and experiences are real and valid. Don’t let your (very valid and real) inner turmoil make you doubt yourself and your self worth. (Kate interjects, “Fck’em. They’re all assholes who are supposed to be helping us and they end up hurting us in the process.”)

So, make yourself stop right now, mid sentence, and suspend your mind. <Well actually, it’s the END of that sentence, but whose counting, right?>

Grrr. If this, my dear, is supposed to be a post to help someone understand and accept their value and to make a plan to go forward, does this of yours sarcasm really belong here?

<Humor is a salve. Dark humor gets us to laugh a bit and temporarily release some pressure. Don’t I sometimes give you no other choice but to laugh when you’re completely encircled in despair? Can’t my charm and delightful repartee cast asunder at least one microscopic iota of pain? Have I no worth myself?>

True. (Nods.) Humor good. Remember that light bulb joke?

So, with a microscopic pinhole of light and the hint of grounding hole, we step forward. Hard as it can be to find and grasp that tiny rope.


While therapists tell us we have value and that we should believe we’re worth healing, they can completely erase any promise of these words by their actions, such yours has done. Made you feel that your experience wasn’t quite true – she invalidated you. Sure, I don’t know her and your conversations, but if the result of those interactions has caused you to feel this way, then shame on her.

We should not have to PROVE ourselves to therapists. Therapists should help us discover ourselves and heal.

Proof? Who Proves What to Whom?

Hey, doctors frequently “prove” a diagnosis to a patient with facts – a blood test, and x-ray. Sure, I buy that. The news may be hard to hear, but if the conclusive diagnosis is cancer, let’s get the treatment underway post haste.

However, if patients have to prove to the doctors what’s wrong, then what the fck is going on in the world?

IMHO, welcome to the mental health system. In their defense, therapists must exercise different skills to make a diagnosis – x-rays won’t cut it. The symptoms of many diagnoses overlap. “Experts” around the world don’t agree on diagnostic criteria (DSM-IV vs. ICD-10). Some experts and therapists don’t believe in some diagnoses. Of those who do, only part are qualified to treat some diagnoses. My first therapist is a case-in-point. After I was diagnosed with DID, she didn’t tell me she wasn’t qualified, she tried to force me to accept something I didn’t believe, and our relationship ended disastrously because of how she handled it.

So that’s what practitioners’ ignorance and attempts to deal with things inappropriately (while believing that they are “doing the right thing”) can get you.

1) Major setbacks in your therapy
2) Renewed doubting yourself
3) Possibly inappropriate and illegal release of diagnostic information


Sadly, horribly, we the patients are subject to all this insanity <heh, pardon me> in our quest for healing. More energy wasted on figuring out the number, that CODE, that goes on the damn insurance form, than the critical first steps of therapy itself!

It’s that whole bullshit “system” that uses labels and numbers for categorization and insurance purposes. For PAYMENT. That “system” is not aligned with what we need in order to heal!

This is a fundamental conflict that has spun my mind as well!

Takeaway? Your frustration is a direct consequence of the mental health and insurance systems.

It ain’t you. Doesn’t make the frustration any easier, but I hope it puts it in perspective.

Don’t accept any guilt or attack on your self-worth because all that is so fcked-up.


This topic is a biggie. Legalities aside, once the info is out of the bag, damage control is

Elysium offered,

“Unfortunately, if the diagnosis is disclosed it becomes more of a damage control thing, because the proverbial elephant in the room has been exposed and you can’t un-ring a bell. I believe this would be the same regardless of what field of work one is in.”

So what can we do?

Outing has a few areas to consider That I’ll meander through in another post.

* Legalities to protect our jobs if our employer finds out
* What protection we have
* How to deal with an outing

– ∞ –

See also:
Table of Contents for all blog posts
Flame-Quenching “Move Along” Standard Disclaimer
Problems that arise treating a DID patient without the skills to do so
Therapist consultation for dissociative identity disorder
Milestones in treatment for trauma: everyone is a fingerprint
Changing therapists – what to consider
Guest Book and Introductions



  BTC wrote @

Superb post. Glad to see you back 🙂

  Batesie2012 wrote @

Regarding outing people, they can only do it legally if you are a danger to yourself or others. In this case, they cannot disclose your diagnosis to anyone unless they have concrete evidence to suggest that you are unsafe to practice your profession. There are other people in the world with DID who hold high profile jobs. Hope everything turns out okay.

  Ruby wrote @

I worry about outing quite a bit– and while it’s true that it would be illegal to break confidentiality without evidence that someone is unable to practice their profession, there are plenty of people who believe that DID does indeed make you unable to do much of anything. Also, while the person doing the disclosing could always be sued, the information is already out there.

I’m sorry people are acting like jerks to you. I hope it works out ok.

  Emily’s Camigwen wrote @

Hi Ruby

Sorry for missing your comment – I have been away from the blog for a month or so. I am the same as you … the stereotypes…. ugh. I just keep doing the best I can at my job and at the rest of my life, and if I were ever to be outed, I have years of history of a successful person both personally and professionally. Part of me would eventually like to come out and be a role model (not a spokesperson) when I am further along in my healing and can handle the backlash better. I just don’t want the outing QUITE YET! 🙂

People are jerks for so many reasons. I have learned in the last year that when people are jerks, it’s not about me or my issues or healing. I am learning to recognize that other people have their own issues, and their responses to me reflect their own problems. It’s not just me. That realization has been very healing to me.

Thank you for writing, and also for your support. Stop back any time.


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