Still no date on this one...

D.I.D. - Dissociative Identity Disorder. Now, here's an interesting diagnosis. It's the modern term for Multiple Personality Disorder. New and improved, updated - bringing it into the 21st Century much like Manic Depressive was updated to Bipolar Disorder - quite possible the most often diagnosed diagnosis.

But let's focus on DID for a moment, shall we? Imagine for a moment having more than one person living inside you. Various personalities which have the potential to emerge at any moment, sometimes mid-sentence. One moment, you're aware of the world as a 30-something year old woman (since the majority of supposed DID cases are female) and you're perhaps looking for a job, buying a slice of pizza, driving a car or having sex.

And then - BAM!

You're a 6 year old girl.

Imagine the frustration, huh?

Now, imagine you're a man with that woman. One moment you're lost in sexul bliss with the 30 year old personality and then BAM, the switch. And she starts screaming RAPE!

Yeah.

Multiple Personality Disorder. That's pretty legit, eh? DID?

What about getting caught while stealing? "Oh, that wasn't me. It was X personality."

Running a red light? "That was my 6 year old alter. She doesn't know how to drive."

Throw a rock at someone or start a fight - "My angry teen came out. I'm so sorry."

Murder? "I don't remember that. It must have been one of my alters. My doctor says..."

Ah, yes. One of my alters. Even MPD / DID has its own catch phrases, words and terms to toss around at the coffee shop or inside a psychiatric groupsession. Something to normalize or attempt to provide a sense of legitimacy to a fucked up thing that's wholly fucked up.

It's a diagnosis prevalent in women with a trauma history and som other personality disorder to boot. Crack the surface of that and there's a plethora of problems to wade through, like surfing the ocean tide rife with jelly fish, seaweed, a few circling sharks and the rusty remnants of a steel-supported dock long since removed.

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I don't remember who it was that inspired this when I hit the bar but it was no doubt someone with DID, one of the most ridiculous diagnoses ever to grace the world of psychiatry, in my opinion. Some docs believe everything and anything they're told by their patients because it's easier to do that than to challenge asinine statements.

There are only a handful of people who come in with a diagnosis of DID, so it had to be one of them. They're all essentially manipulative to the core and become quite offended when told they're full of shit (diplomatically) - usually without switching alters. Go figure.

No date entered.

The first patient he'd ever come in contact with was an older woman who liked to smile. He was fresh out of collegethen without a thought in the world related to his nursing license. He'd majored in psychology in school and done fairly well despite his penchant for marijuana and Jack Daniel's, consumption of both earned him consistent A's. Youth and innocence, resilience with a good heart. That's what he was about back in those days. Hell, that's what the whole world was about, as far as he was concerned. The sky was the limit, to coin an old cliche and why shouldn't he? For him, there was only upward movement when it came to his prospects for the future. He was a college graduate and he was working a professional job.

And so, there he was, walking the unit with the first patient he'd been assigned to since graduating. His first job. His shining star. They walked together around the unit. Sometimes he looked at her and for the life of him, she never looked back. No problem, though. What did that matter? He was there to make things ok, wasn't he? Psych counselor extraordinaire with a heart of gold.

Right.

Yeah.

That's a cheap shot at myself. Cheap and inappropriate. That's life.

Damn, I'm angry with myself, aren't I?

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edit: I don't remember what started this or why I got so down on myself. It happens sometimes. I remember that patient, though.

She was always sweet and pleasant, we'll call her Tina. She used to tell me about the clowns in her head, laughing. And I remember initially thinking that that wasn't such a bad thing until she told me about how they were laughing at her, with sharp, pointed teeth and they told her they were going to kill her. Or she had to kill herself. "They want me to die.", she'd said at one point - but she still smiled.

And I remember when she came into the ER one night, dead on arrival. Her liver had been failing for a long time and one night it and a lot of other things in her just quit. This was in the 90's. I stayed with her while the medical team did their work and straightened her out / cleaned her up when they called her time of death. And I remember holding her dead hand for a little while after and saying good bye.

My first patient.