Diagnosis and seeing switching

Following quote comes from another thread, but I did not want to go off-topic.

salted lipstick wrote: They won't be giving you a diagnosis of DID after the first session because they need to have actually seen you switch to confirm and make the diagnosis.

How would they be able to tell though, I wonder.
I think I did a thread once on that subject.
It seems the idea was that it would need to be some alter that is very different.
But since some alters are not like that.
What if you do not have those?
It seems that only extreme cases could be diagnosed.
So what if it is not the case?
Does DD-NOS fits for those cases?

PS: This is open to anybody that want to answer, not just salted.

I'm in the same predicament. If people in the real world don't necessarily know when we've switched, if I don't even know for sure if I switched/lost time, how would the T "know?"

And what about other illnesses. How does a psychotic person prove that they are hallucinating? Doesn't the shrink just kind of have to believe them? I mean, (and I'm playing devil's advocate here)they could just be faking a delusion/hallucination in order to get drugs/attention.

Yes, exactly. It is the same problem with psychosis.
Do they want me to go psycho on them?
I mean, seriously, they do not even realize I am not well, when it does happen.
But I know I am not, so what then????

When a client switches with amnesia, the client is the last to know. Often the therapist will notice. For example, my therapist noticed one of my microamnesias. I was talking, then I said something shocking, then I looked disoriented. My therapist asked me to repeat what I just said. I repeated what I remembered just saying, which was what I said immediately before the shocking thing. She then told me what I had actually just said, and I denied saying it.

I think DDNOS is used for a while, just as a precautionary measure. As for switching, I don't think it has to occur with the amnesia. The amnesia can be for even 1 past event "too extensive to be explained by simple forgetting," not necessarily for the switching episodes. And the one diagnosing doesn't have to be the one seeing it, just a reputable source. For example, my p-doc has not seen me switch that I am aware of, but he has the reports and discussions from my T.

One thought that boggles my mind is that after some time in therapy, etc, some people may recover all the memories from the others and start being completely co-concious, though they still have switching. Does the DID diagnosis still apply? Probably not, but DDNOS is just a strange diagnosis that can mean pretty much anything. I wish they would have two DID parts in the DSM - like DID-A for having "others" as well as amnesia and DID-NA for no amnesia.

InfinitD wrote:I wish they would have two DID parts in the DSM - like DID-A for having "others" as well as amnesia and DID-NA for no amnesia.

Now that is genius!

Amnesia and the DSM still baffles me.

Remy, who did my assessment, put down on my report that he witnessed amnesia within session. I have no idea where, why, or how. As far as i'm aware I experienced co-consciousness but no amnesia. There wasn't a "full" switch. I did not let Anger come raging through. And I had a conversation with Alice in my head, and she very quickly took control of my hands but other than that we didn't fully switch visible for him. But it was enough for him to not need to ask someone from the system to come out if they feel comfortable at the end, like he has done before to others.

Also, Remy is also of the opinion, that you do not need amnesia for present day to be DID. Amnesia for past events, for him, is enough. I argued with him that I do not have amnesia for present day. He argued that I do. We agreed to disagree. I think it's a mistake. But either way, he said, he would have diagnosed me with DID because of the seperation of my alters. Even if we are all co-conscious with each other.

Bourbon

bourbon wrote:I argued with him that I do not have amnesia for present day. He argued that I do. We agreed to disagree.

I have had exactly this kind of conversation with someone who admits to having dissociated ego states, who I am convinced has DID. This person's amnesia is obvious, yet this person is unaware of it. This is known as amnesia for amnesia, and it is a characteristic of dissociative amnesia.

I suppose if you have amnesia, it is hard to tell, thus the conundrum.
I had some strange experience today when talking to a T.
Somehow last Friday, my depersonalization completely stopped for the first time in 7 months. *pat in the back*

Strangely, or not, now I am very aggressive and intransigent. While last week I was like a lamb to the slaughter. I was talking about a paper she wanted me to sign, and I was threatening her to sue them for malpractice because of a clause I did not like.

What stroke me though, is that at some point she asked me for some "concrete example" of something I was saying. Strangely enough, I could not come up with one. I knew they were there in my memory, but I could not recall. I got impatient and fortunately found one that more or less matched from what I had just said. Still, on the spot I found it strange that I could not get to those ones that I know are more important and accurate for me, but they were blocked.

Don't know if it counts as some sort of dissociative amnesia or not?

So, is it possible to be very dissociative (derealization, depersonalization, spacey etc) and have amnesia, but not have parts? Or at least not parts with amnesia?