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Dr. Bob is Robert Hsiung, MD,
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Posted by Aphrodite on August 12, 2004, at 15:03:22
In reply to TMS, posted by Pfinstegg on August 12, 2004, at 14:50:11
Posted by Aphrodite on August 13, 2004, at 6:59:51
In reply to TMS, posted by Pfinstegg on August 12, 2004, at 14:50:11
Pfin,
I am curious what your feelings are about medication (ADs) as it relates to your previous discussion of therapy trying to integrate the differing parts of yourself. I am not on medication, but yesterday after 10 months of difficult therapy, he gently suggested it. I rebelled at first -- like he was trying to silence some of the more troublesome parts of me -- but now I think I'll consider it. I do not know if you are on meds or not, but I fear that it may make the therapeutic job of working on the ego states more difficult. You do not have to answer, of course, if you prefer not to. Or, you could email me at babbleaphrodite at yahoo dot com, or not at all. I understand either way.
Anyone else have any thoughts on meds and how they affected the work of ego states? It frightens me.
Posted by DaisyM on August 13, 2004, at 10:38:02
In reply to question about meds and ego state work » Pfinstegg, posted by Aphrodite on August 13, 2004, at 6:59:51
One of the huge issues I have is not sleeping. The dreams are terrible and they wake me up and I stay up the rest of the night to avoid more of them. A few months ago, my therapist became very concerned about this because it was contributing very heavily to the suicidal ideation...I was too tired to cope. He talked about medication and suggested I talk to my MD or he would refer to a doc. Sounded fine to me.
I left his office and an hour later freaked out. It was very much like what you said. The parts of me that have been so contained, so silenced where having a fit that we were trying to silence them again. Because she is mostly out at night. It was one of the worst episodes I've had...I literally lost the next morning, couldn't move off my bed. So if this is the discussion just prior to last night, I can see why you had a crisis.
That said, after much more discussion, I do have something to help me sleep now. I don't take it every night but there are times when I've taken it early and put myself to sleep. It helps. I've heard so many differing opinions on the idea of medications. The idea is not to mask your feelings and pain but to make things manageable between sessions so that you can live your life.
My son's therapist stressed that medication was a tool to bring the anxiety down enough to learn how to deal with it, if possible, without medication. But until the anxiety came down in the first place, nothing was getting past it. And that is exactly how it worked...he went on, stabilized and worked hard to learn other things. Now we've weaned him off. He is struggling again so he might go back on. But it isn't a life sentence just because he started taking them. But if he needs them lifelong, that is OK too.
I totally understand your hesitation. I share it. Sleeping aides were a huge first step for me. And they've help me tolerate going into even darker places. I think you should keep talking about it. Since you are already invested in therapy, I doubt whether they would shut down your progress.
Posted by Shadowplayers721 on August 13, 2004, at 12:12:12
In reply to Re: question about meds and ego state work, posted by DaisyM on August 13, 2004, at 10:38:02
Some of mine aren't touched by meds at all. When I was in the hospital, they gave me the shot to calm me down. A little girl came out and started talking about another one. She was wide awake and alert. Meds didn't affect her in the least. You couldn't knock her out with anything. Others initially will fight against them and have some weird reaction, then they will give up and all them to do their action. Meds are tricky with me.
Take klonopin. Sometimes, it knocks me out. Other times it does NOTHING. Then, others, it just calms me a bit. Now, this is the same dosage 0.5 mg It just depends.
Posted by Pfinstegg on August 13, 2004, at 12:51:53
In reply to question about meds and ego state work » Pfinstegg, posted by Aphrodite on August 13, 2004, at 6:59:51
Hi.. I'll answer anything! (or at least offer my 2 cents). You asked a wonderful question, and there isn't a simple answer. Generally speaking, I think therapists (my analyst is among them) who do work trying to integrate separated ego systems prefer to use little or no medication. However, during the most difficult times, many will suggest them. Mine wanted me to see a pdoc a year ago at a time when the good effects of TMS were wearing off, and the therapy was becoming extremely painful. I went on Lexapro between 10 and 20 mg. It made everything much more bearable, but it did have a dulling, anhedonic effect on me, and what I was able to express in therapy. So we decided to gradually wean off of the Lexapro. Because I had taken various SSRIs and atypicals for eight years previously, I was very susceptible to their dopamine-lowering, anhedonic effects. Instead, I'm presently taking Wellbutrin 75 mg. of the old-fashioned regular release. This is a very low dose (300 xr being an average dose), but it is enough to help me have what feels like more normal dopamine levels, and to tolerate the stress and pain of therapy. I also have trouble sleeping, and take klonopin 0.5 about every other night.
So, to sum up, we are trying to keep everything at very low doses, but we're not at the ideal of no medicaton at the moment. I do find that, the less medication, the stronger and more spontaneous my feelings are in therapy.
Posted by Dinah on August 13, 2004, at 13:28:46
In reply to question about meds and ego state work » Pfinstegg, posted by Aphrodite on August 13, 2004, at 6:59:51
Some medications have more effects on it than others. You can always try, and if they are shutting you off from parts of yourself, back off.
I find that the very low dose combo of klonopin and depakote I'm on keeps me on even enough keel that I'm not careening from crisis to crisis, without affecting my ability to reach different parts of myself. When I'm extremely agitated, I take the occasional Risperdal - which does tend to cut me off; but on those occasions I feel so darned bad that I don't mind being cut off.
Posted by Aphrodite on August 13, 2004, at 17:56:09
In reply to Re: question about meds and ego state work, posted by DaisyM on August 13, 2004, at 10:38:02
You're so right, Daisy, that part of the session in which he suggested a pdoc and meds set me into crisis mode. I also couldn't tolerate the thought of he and another person talking about me. Also, since he sends a summary when he refers someone to the pdoc he works with, I am afraid she would have a preconceived notion of who I am.
So, he suggested I find a pdoc on my own and have control over the situation. I was already thinking that I should start small and just get something to help me fall asleep and stay asleep and see if I can then tolerate everything else. Thanks for the insight, as always.
Posted by Aphrodite on August 13, 2004, at 17:59:53
In reply to Re: question about meds and ego state work » Aphrodite, posted by Pfinstegg on August 13, 2004, at 12:51:53
> I do find that, the less medication, the stronger and more spontaneous my feelings are in therapy.
>
>That's what I would have guessed. I'm afraid that if meds suppressed my sorrow they would also suppress any joy that might be found. I think that if I can tough it out, I'd rather be in the thick of it all, feeling everything, so that the differing parts could integrate fully.
Of course, I may just be saying this because I feel a little rebellious toward his suggestion:) Those tantruming little inner children can be difficult!!!
Posted by Aphrodite on August 13, 2004, at 18:03:50
In reply to Re: question about meds and ego state work, posted by Aphrodite on August 13, 2004, at 17:59:53
Posted by Pfinstegg on August 14, 2004, at 10:05:38
In reply to Above for Pfinstegg ^^^^ (nm), posted by Aphrodite on August 13, 2004, at 18:03:50
As you can see, we compromised (he wanting meds temporarily, me not wanting them). I had to stop and remember that he's been doing this work for 30 years, and probably knows when to suggest them. Since I've been able to get by on very low doses, I don't think it's making a lot of difference one way or another. The Wellbutrin, if anything, makes one's feelings stronger, and the Klonopin for bed-time only.The SSRIs- well, they all vary some, but the Lexapro seemed to take away all my dreams, sexual desires and strong feelings in general, so, for me, it was a poor choice for in-depth work. I am noticing that, off of it, my other ego states are a lot closer to the surface, and easier to get out into the open. I also make lots more sudden, unexpected slips of the tongue - comments which only the *other parts* would make. As an example:
My T. brought up something I had mentioned a number of times- a vivid mental picture of my father having been castrated, with blood all over his legs. He asked, "When did you start to have that thought?"
Without knowing I was going to speak, a voice in me quickly said " after". I was so shocked to hear myself say that, as I don't remember what he actually did to me. It helped us a lot to start chipping away at these unconscious memories- I am remembering a bit more almost every time I'm there. I don't think this would have happened if I'd been highly medicated, but the low levels seem to be helping me in my own life, while not interfering with therapy
Posted by Aphrodite on August 14, 2004, at 14:49:05
In reply to Re: Above for Pfinstegg ^^^^(caution - may trigger » Aphrodite, posted by Pfinstegg on August 14, 2004, at 10:05:38
Thank you for all of this helpful information. I will keep this in mind if I should end up consulting a pdoc.
Sounds like you are doing such hard work. I hope there is much healing on the other side of it.
Posted by daisym on August 14, 2004, at 17:07:23
In reply to Re: Above for Pfinstegg ^^^^(caution - may trigger » Aphrodite, posted by Pfinstegg on August 14, 2004, at 10:05:38
Have you tried free flow writing giving your therapist a voice from your head and seeing if your inner child will answer? It is very compelling, especially if you do some deep breathing before you start writing.We started by me walking my therapist through my childhood homes. I was the tour guide, based on my age at the time. (this was all on paper -- I did it without him being with me.) As we walked the halls and put our heads into rooms, I would tell him about things that went on, or who had that room, whatever. He had me write about how I felt about each room, during the day and at night. And then he had me think about questions he might ask if I described something.
For example:
Me: When I was 9, I slept with my baby sister.
Him: You shared a room?
me: No. I had my own room.
Him: But you slept with your sister. Why?
me: I was afraid of the dark.
him: A nightlight wasn't enough?
me: No.
him: was she afraid of the dark?
me: No. I protected her.
him: from the dark
me: No. from what happens in the dark....and so on. I have done this now with almost all of the houses we lived in. I can't get through one age range but that tells us there is something there I'm not ready to deal with. We have an agreement that I will show him these writings, or at least tell him about them when I use this technique because he doesn't want me to "sit" on new memories and allow them to become new secrets I have to keep.
My gate keeper is so strong there are rarely slips of the tongue. But, if my therapist talks directly to my younger self, she will now talk about what happened with him. I must say, it was easier to have the adult just tell in broad strokes what happened. Because her recollections are loaded with the emotions. And that makes my brain freeze and words are hard to find.
I wish it wasn't this hard. For any of us.
Posted by Pfinstegg on August 14, 2004, at 19:04:53
In reply to Re: Above for Pfinstegg ^^^^(caution - may trigger, posted by daisym on August 14, 2004, at 17:07:23
I wonder if our therapists trained together! He asked me to bring drawings of the room arrangements in the house I lived in as a child, and kept them in front of him for weeks while he asked the same sort of questions. We started with the girl taking him on a room-by-room tour of the house, and telling him where each piece of furniture was, where the beds were, how she felt at various times of the day in the rooms, all very detailed and at a slow pace. Once we had done that, the girl seemed to decide that he was a safe guide, and she could start to talk to him more directly about her thoughts and feelings. It was such a new, startling experience to realize that, while *I* really trust my analyst and want to hurry up and get my problems solved, *she* has to proceed very cautiously-she has difficulty knowing whether he can be trusted or whether he is another abusive male. My analyst does some amazing things (like yours)- one time, it popped into my mind to talk about wading in brooks when I was a girl (I grew up on a farm). He said, "maybe you would like to come and see the brook outside my balcony." I said. "OK". He went over and drew the sliding door back, saying, "you can see it best if you come out on the balcony". We both stood on the balcony; there was a brook running through a little park with clear water and a tiny waterfall.
the girl: "it's beautiful- do you wade in it?"
T: "no, but I cross over those stones when I walk over to pick up my car after it's been serviced." (he points)
girl: "you do? It's nice to have everything you need nearby." (she looks at him, not afraid). "I'm going to lie down again."
T: "OK.
girl: "that's your brook"
T: "you might like to go and walk there sometime"
girl: "I'm going to. You have everything here-sunlight, fresh air, goldfinches (there's a birdfeeder on the balcony) and a brook- and you have yourself- that's the most important."
T: "mm"
girl: "and I have you, too."
T: "yes, you do- I'm your doctor"
girl: "that's so good- mostly, I've had to be my own doctor."
T: " yes, but now you have me- I'm going to be here as long as you need me."
girl; "I'm so happy!"
Reading what I've just written, I know it sounds a little silly, but in fact, it really WAS the girl speaking to him, and he was speaking directly to her. It sounds like such a simple exchange, but in fact it was moving and powerful- and very helpful in getting the girl to feel safe enough to speak to him more fully- she felt much safer because he recognized that she liked to wade in brooks- and just followed his own instincts! Invariably, when he does follow them, like that- really taking chances- he's so on target! Things like this happen only occasionally, but are so meaningful and helpful when they do. When I tell him that, he says they are "co-created" interactions- he never knows when they'll happen either, but he does also put a high value on them.
What you said is so true- it is SO much harder to bring the actual child into the therapy relationship to tell her story; she is so much more enraged, fearful and disgusted than the adult, who, as you say, kind of knows in general but avoids the most painful feelings. I think the little exchange I printed out is an example of the girl having a really new experience with her analyst- one that's safe and fun. Do you have those?
Posted by Pfinstegg on August 14, 2004, at 19:20:43
In reply to Re: Above for Pfinstegg ^^^^(caution - may trigger » Pfinstegg, posted by Aphrodite on August 14, 2004, at 14:49:05
At the moment, this seems like a general three way post with you and Daisy, which I appreciate very much having, but I wanted to thank you, especially, for your kind wishes. The therapy I'm having now is MUCH harder than my previous attempt at it, but I actually feel fortunate and privileged to have found a therapist like this, and I do feel very hopeful and confident about the future- if I can just make it through the present!
You know I wish you the very same.
Posted by Aphrodite on August 14, 2004, at 20:01:12
In reply to for Aphrodite, posted by Pfinstegg on August 14, 2004, at 19:20:43
Thank you so much for sharing your poignant conversation with your therapist. I truly made me cry . . . and cry . . . and cry. (I grew up on farms, too.) Your therapist sounds so gentle and caring. I am inspired by the fact that you could actually talk as the girl. The only way I do so is the interfacing me saying, "She would like to say . . ." or "I think the little girl is feeling . . ." I never let them fully out for fear of losing control.
I'm trying to be patient with myself on these matters. It seems like an uphill climb, but the other option just doesn't seem worth living. Thanks for sharing.
Posted by Dinah on August 14, 2004, at 20:33:32
In reply to Re: childhood rooms » daisym, posted by Pfinstegg on August 14, 2004, at 19:04:53
That *does* sound like a moving and powerful exchange. I thank you for sharing it.
I don't think my therapist could be that spontaneous, though maybe I'm not giving him enough credit. And he talks to whoever shows up for therapy, but the difference in how he talks is slight if present at all.
Posted by Pfinstegg on August 14, 2004, at 20:40:09
In reply to Re: for Aphrodite » Pfinstegg, posted by Aphrodite on August 14, 2004, at 20:01:12
Oh, I'm glad it was OK to write that, and that it really meant something to you. I was afraid it sounded kind of silly, though it was very meaningful to me. It's only just recently that I can let go enough so that she speaks. Before that, I always said just what you say- "she might say.." or " I guess she thinks.." My analyst helps tremendously with this, by always being a bit ahead of me in speaking directly to the girl. He takes care to use simple language, and a gentle. comforting voice, and he knows all the good things about the girl's life- like the brooks and farm animals, frogs and salamanders, spring flowers and the ancient horse who used to lie down if anyone got on his back, and brings those up to help her get started. I could see him doing that for months, but still was not ready to let my guard down enough to allow the girl to really speak. She was dreading what would happen after she had talked about the good things- how bad were the bad things going to be? Now, she and I know that when she's ready, it won't be unbearable- we can go back and forth, from *her* to *me*, both my T and I knowing which one is speaking, and that each part is real. As it happens, we do run the gamut of fear, pain and sorrow, but there is also joy and delight. I really know, now, that doing this kind of therapy can lift those terrible burdens which abuse inflicts on us- I can feel it happening, bit by bit, but it's QUITE SLOW.
I mentioned a couple of interactions which meant a lot to me- one terrifying, and one fun and happy. I would love it if others would do the same!
Posted by Dinah on August 14, 2004, at 20:49:29
In reply to Re: for Aphrodite, posted by Pfinstegg on August 14, 2004, at 20:40:09
>
> I mentioned a couple of interactions which meant a lot to me- one terrifying, and one fun and happy. I would love it if others would do the same!I really wish I could. At the moment, I can't really think of anything profound - positive or negative. Although I might have mentioned things as they happened. Nothing stands out though. I'm closing my eyes and trying to remember. Lots of impressions... But nothing like what you described. Therapy with any part of me is probably mundane and plodding, with lots of repetition.
I remember how it felt, the first time. And a few times I totally surprised myself. But nothing truly profound.
Posted by Pfinstegg on August 14, 2004, at 20:58:57
In reply to Re: childhood rooms » Pfinstegg, posted by Dinah on August 14, 2004, at 20:33:32
Honestly, Dinah, I fought like a cornered animal when my analyst first gently suggested that I had a dissociated childhood self. I was completely terrified of what the implications of that might be- would I fall into a heap of incoherent pieces? But it's becoming an amazing journey, though a hard one.
I've always assumed there's just *one* Dinah to show up, but that, at first, she didn't really want to show up at all. Now, she does want to, and she's developed a powerful bond with her T. For her, there was just *one* Dinah, who needed to make a healthy, strong connection- and she did it. Does this seem about right? (I'm getting all mixed up between pronouns, which I also do with my analyst-sorry!)
Posted by Pfinstegg on August 14, 2004, at 21:12:18
In reply to Re: I wish I could, posted by Dinah on August 14, 2004, at 20:49:29
I bet you could if you took note of what comes to mind just as you are waking up, or the things you think of about him to comfort yourself when he's away. Maybe some of the things that have meant the most are more in the non-verbal realm- like peaceful, connected silences, something in his tone of voice or sense of humor, the expression in his eyes, the calmness and relaxation of his body, etc. Not letting you off the hook, here, Dinah!
Posted by Dinah on August 14, 2004, at 21:21:55
In reply to talking to who shows up..., posted by Pfinstegg on August 14, 2004, at 20:58:57
It's hard for me to talk about. And I suppose some would say there is just one Dinah. That I just gain access to a deeper level of consciousness or something. And maybe that's true. Maybe there is no me and me at all.
I don't have a dissociated child self. Despite the fact that the part of me that formerly did not have access to the ability to speak or be "out" has a visual picture of my(her)self as looking like this:
http://f2.pg.photos.yahoo.com/bullyforyou77
I(she/whatever) also realizes my actual chronological age. I just have an intense fear of being a woman and refuse to admit to being one.
I and I have completely different feelings/thoughts about a fair number of issues and people. Diametrically opposed often, but often not. My therapist instantly knows who he's talking to because style and posture and things down to laughter are different. My therapist once remarked that our laughs were different, but the fact is that my emotional self doesn't laugh at all. My husband and work associates generally don't have any clue, although my husband might ask if something's wrong. I've posted here when I was each, and I don't think anyone's noticed unless I tell them. There's no amnesia. I don't have DID. I don't know whether it's truly two separate ego states or not. I and I certainly prefer to think of ourselves as two separate ego states. But that doesn't mean it's so. It might just be two separate layers of consciousness or dialectics in action - conflicting feelings about things. But each part of me is pretty congruent to itself. I can predict what I will do and what I will do. :) It used to be that I didn't have any idea what I was going to do. So if this is a fiction, it's a useful one that helps me understand why I do the things I do.
It's as clear to me who I am at any given time as it is to my therapist. Sometimes there's a lot of leakage of feelings from the part of me that doesn't control consciousness, so that whatever part does have consciousness is influenced by the other. Sometimes there isn't.
If you are wondering who you are speaking to, it's almost always rational me. Although I present things from the point of emotional me a lot, particularly on Psychological Babble, where my own point of view wouldn't be terribly interesting. My therapist is an idiotic hack who's trying to take me for all I'm worth. Etc. Etc.
Posted by Pfinstegg on August 14, 2004, at 22:08:59
In reply to Re: talking to who shows up..., posted by Dinah on August 14, 2004, at 21:21:55
I'm so glad to see that photo of you. Dinah. I don't know if it's been around, and I've just missed it, or if you just put it there. Anyway, it's great to see it- and I know that those wonderful essentials which are there in the photo don't change throughout life. I can see how fair you were then, and how you have sort of an impish smile and a very direct, open gaze. You were such an appealing girl; I think that gaze is kind of rare in children- so alive and open and kind of validating to the person looking at you. I couldn't help thinking- do you close your eyes when you are with your T (maybe you don't any more) because you have such a magnetic gaze that it's a bit scary?
The rest of your post brought up lots of thoughts. Although you of course don't have DID (even I don't have that), it sounds as though maybe you do have some less than fully integrated parts- at least that seems to be one way your therapist responds to you. If you were to talk abou this stuff with my analyst, you'd find that he thinks everyone has some degree of dissociation- it's just another way of saying that we do have unconscious, unknown parts of ourselves. Most people keep them under pretty tight control. If you have real DID. the other parts find ways to express themselves, but if you just have dissociative tendencies, they are repressed, and instead of getting expressed, they cause anxiety and depression- constant fear that they WILL find their way out, and that that would be catastrophic for some reason.. So one goal for everyone would be to lift the repression, and find out, in someone like me, for example,that there really is a dissociated child who bears the burden of abuse. But for someone who doesn't have an outright history of abuse, but rather more subtle interactions with not-so-healthy parents,there would be more simple repressed emotions- like anger, rage, desires to retaliate, detachment, and then also dependency, neediness- the whole range of feelings which your parents were unable to help you integrate into a healthy self. Of course, if you have a dissociated self, you also have all these repressed emotions- in both parts!
I guess the important questions to ask ourselves, whatever our diagnoses are, 1) am I connecting in a deep and healthy way with my T, survivng cycles of rupture and repair, and having a gradually more secure attachment until I've gotten enough of what I needed, and 2) do I feel like an increasingly whole person who cares about myself and knows and can accept all of me- not beating myself up about mistakes, limitations or failings? 3) Can I use my gifts and talents more than I could before therapy?
Do you have other things you'd add to this? (or subtract?) Thanks for the great pic, Dinah!
Posted by Dinah on August 14, 2004, at 22:26:31
In reply to Re: talking to who shows up... » Dinah, posted by Pfinstegg on August 14, 2004, at 22:08:59
> I couldn't help thinking- do you close your eyes when you are with your T (maybe you don't any more) because you have such a magnetic gaze that it's a bit scary?
I always say I keep my eyes closed in therapy because I see better without distractions. :) I think I mean I can concentrate better on what's going on and feel the energy in the room better.
>
> I guess the important questions to ask ourselves, whatever our diagnoses are, 1) am I connecting in a deep and healthy way with my T, survivng cycles of rupture and repair, and having a gradually more secure attachment until I've gotten enough of what I needed, andI'm doing a really good job with that, and developing an increasing sense of safety that I never had before.
2) do I feel like an increasingly whole person who cares about myself and knows and can accept all of me- not beating myself up about mistakes, limitations or failings?
I'm not so good with this one. :) And becoming whole in the sense of integration isn't a goal of any part of me.
3) Can I use my gifts and talents more than I could before therapy?
There's a definite yes.
I suppose I think of it in way too concrete terms. Pretty typical for me. :) Do I function better with or without therapy? If I function better with therapy, how much better? Can I justify the cost? What are the costs of not going to therapy? Am I a better mother?
And the biggie to me was always understanding why I behaved like I did. Therapy has answered that for me, and for me understanding the why of something is like having a key to my universe. I still may do things I don't like, but I understand why I'm doing them.
> Thanks for the great pic, Dinah!
You're welcome. It's my favorite one of me. I have ones where I'm cuter, but this one seems to represent best who I am in essence.
Posted by Dinah on August 14, 2004, at 22:31:02
In reply to Re: talking to who shows up... » Dinah, posted by Pfinstegg on August 14, 2004, at 22:08:59
P.S. I don't think I showed *that* photo on board before. I showed some of me when I'm younger. And I'll probably take that one down fairly quickly.
But I look waaay different now, and I don't think it's identifying to anyone except my family.
Posted by Pfinstegg on August 14, 2004, at 23:11:42
In reply to Re: talking to who shows up... » Pfinstegg, posted by Dinah on August 14, 2004, at 22:31:02
Yes, I think I saw one of you earlier when you were about 4 or 5. But the one you put up tonight is much more interesting because you're older, and there's so much life and personality in it.. I know you look a lot different now- don't we all-. but I still think a person's smile and gaze-and how those make other people feel- essentially don't change throughout life. Now that I've had a careful look at that picture, I bet I would recognize you if I ran into you. I bet you think I wouldn't, but I might surprise you! Of course, you would have to give me that upward look- and the smile, too.
As to the goals of therapy I mentioned - you can answer a definite yes for two out of three- the secure connection, with all of its benefits in feeling safe in yourself, and also in freedom to love chosen others in your life even more deeply, and the greater use of your abilities and talents. That's a LOT! As far as the third one goes- the feeling of integration- that may not even be a goal of yours- that may seem more crucial to someone like me, who does have disturbing feelings of fragmentation at times. It sounds as if, even though it took nine years (so far) you
have actually been accomplishing in therapy what everyone wants to, but many don't. It doesn't sound like "maintenance" to me- *growth* would be a lot closer! (also, you're not finished yet)
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