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DID or Factitious?

answered 12:28 PM EST, Sun August 21, 2011

firstpersonplural Boston

I have been in and out of numerous treatments for an eating disorder over the past few years. I knew of one reoccurring traumatic event that happened when i was from the ages of 7-12. However, upon going into a treatment that focused both on Trauma AND the Eating Disorder and used a method that I've grown to really find helpful with my system is IFS.

However, as they unfolded a few more traumatic events that I did not even remember happening (except brief short memories I always thought I was "gross" for making up, "daddy would never do that"sort of thing). My therapist at treatment and I made a timeline of events that certain parts remembered, based on my father's abuse, and we believe it happened from, perhaps as young as 2 until the last that I almost remember it, but I was watching, not there, on my 18th birthday. and i've had body memories for years; i just never knew what they were. I have so many blanks in my life, especially in my childhood, so being told that things happened freaks me out. Even when I talk to my mother and she asks if ai remember this or that and I don't. I've known my system for a while; maybe about 5 years that the original two parts came, and then onward from there - especially as they started coming out, expressing real personalities and overtaking me infront of staff and peers after a few months, I've noticed that many only come out when I feel generally safe.

I was diagnosed with DD-NOS, and the diagnosis, even that, embarrasses me. I feel like a crazy person when parts come out and buy things I don't remember buying, rearranging things, etc etc. It's too much! However, the founder of IFS, Dick Schwartz, is a good friend of my therapist's, and he was going to give the unbiased diagnosis of whether or not I truly have DID. I hope you believe me when I say that I don't even want a dissociative disorder, I don't want dissociation, PTSD, let alone DID..

But he was scheduled to come on a Friday and I left due to insurance on a Wednesday.
My team decided that I either most likely had mild-DID or a factitious disorder because "some of my stories of my life were too factual, or too broken up and not connecting" but the reason they don't connect is that I honestly don't remember. I want to go back to this tx facility when I go back into residential tx for trauma, but should I face them again because maybe they're right and I don't even know it, or should I go somewhere else for alternate opinion? I know you don't know me, but I looked up factitious disorder and I don't believe that such a disorder fits me. I don't want the trauma I have and I'd gladly say I made it up if I had. I wish i'd made it up.. but I didn't, you know? What should I do? and does it really sound like I maybe have a Factitious Disorder? Is it common for therapists to debate between both?

Ed Schmookler Says...

E. Schmookler

PhD

Hello, firstpersonplural,

Let's start by me saying I am not in a position to diagnose you. I would have to see you, interview you, and perhaps even get to know you over a period of time So anything I say must be understood within that context.

Let's next talk about Fictitious Disorder. I don't know who is saying this. To answer your last question first, no it is not common for therapists to debate between both, as far as I know. In fact, I had to look up the criteria for Fictitious Disorder, since I've never heard anyone use the concept before. The criteria listed are:

"DSM-IV-TR specifies three criteria for factitious disorder:

The patient is intentionally producing or pretending to have physical or psychological symptoms or signs of illness.
The patient's motivation is to assume the role of a sick person.
There are no external motives (as in malingering) that explain the behavior"

So from the sounds of it, you don't seem to fit those criteria, because you are clearly not wanting to have this disorder or trying to make it happen.

I'm not sure why everyone is having such a hard time deciding what you are dealing with. I do a lot of work with people with Dissociative Identity Disorder and other dissociative disorders, and your picture as you describe it (with different parts holding different memories and coming out at different times) is entirely consistent with Dissociative Identity Disorder (DID).

There are still therapists who have a hard time accepting that this disorder exists. But when you sit with it in yourself or in your office, it isn't so hard to believe, is it?

You say, "It's too much!" Yes, it is. In fact, that is why DID develops -- to cope with traumas that are too much to bear. So yes there is a lot of suffering, and having a good therapist or treatment program is important in order to begin to heal from all the stuff that life gave you.

You needn't be embarrassed by this diagnosis. It is just what our minds do when we have too much to deal with when we are very young. It is actually a very creative process -- developing different parts to deal with overwhelming events.

I am unclear about the situation at IFS in relation to the issue of your diagnosis. I will send you a separate email with my email address, and maybe we can discuss this further, if you wish.

If you are unclear on your diagnosis, and if you want to get clear, then by all means do seek alternate opinions. You should see someone who has substantial experience dealing with DID and get their opinion. I don't know what the statistics are now, but it used to be that the average person with DID would spend 8 years in the mental health system before getting the proper diagnosis. If you are still uncertain and you actually want to know, then by all means get some clarity with the help of someone who has some knowledge.

I really can't tell you whether or not to go to IFS, as I don't know them or what they are offering. But I will be glad to talk further with you about that via email.

Hope this helps.

DID or Factitious?

Ed Schmookler Says...

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