“Like Swiss cheese”: the nightmare of memory lapses.

Photo by Alexander Maasch on Unsplash

My last conscious memory was of lunch at home. It follows: Nothing! The next thing I consciously perceive is the hustle and bustle of an intensive care unit in a hospital. What happened? I’m lying in a hospital bed, hooked up to surveillance monitors, asking a nurse what’s wrong with me. She says I have poisoned myself with drugs. After somatic monitoring, I am admitted to the psychiatric hospital by means of preventive placement.

This diary entry shows the nightmare of every patient suffering from dissociative identity disorder (DID, syn: multiple personality disorder): One unconsciously harms oneself and afterwards cannot remember it — only the physical consequences bear witness to what happened. This situation sums up two aspects of clinical DID manifestation: an ego-state, which is dysfunctional (means not operating normally/properly) and so-called memory lapses (=dissociative amnesia). Before I was diagnosed with DID, I often hurt myself unconsciously, but I couldn’t explain it afterwards. Further I couldn’t remember daily things. Physicians diagnosed a borderline personality disorder (BPD) with “dissociative episodes”. In this sense: an extended BPD version. Already at the moment of this diagnosis, I was unhappy with this explanation of my memory lapses. Combined with the fact that I had auditory hallucinations (voices) that actually don’t fit BPD either, I actually always felt like the diagnosis wasn’t complete. I knew every human has a natural amnesia (early childhood: initial 3–4 years) and for a few events until school. Of course, there is also a certain forgetfulness in healthy adults — in DID patients, however, this takes on a magnitude that makes everyday life enormously difficult and therefore the suffering pressure is great. Here I would like to note that in medicine (especially in psychiatry) it is a philosophical question anyway. There is a continuum from healthy to sick. Only when a certain threshold is crossed and usually the pressure of suffering or the restriction of the quality of life are great enough, a diagnosis is made. People with DID can have no memories for single events or whole journeys — they are often told by others what happened. For example, I once travelled from one border in the west of Switzerland to the other in the east without “witnessing” it. This can be scary and entertaining at the same time and is difficult to understand when you are not affected by DID. What the f*?! It is difficult to imagine that such losses of control also have amusing side effects (e.g. when Tim went to the hairdresser ;-))

Dissociative amnesia (a component of DID) really impairs daily life and causes difficulties to complete, for example, studies, or to work. Further, it is often socially disadvantaged: as you can imagine, maintain a relationship is challenging with dissociative amnesia. It can happen that DID patients do certain things during their “blackouts” that directly affect others. So, my husband told me that I already wanted divorce two times — what do you think, which of my ego-states was present in these situations? What I noticed recently, also immediately writing down events, thoughts or emotions could be very impolite. Today I visited my family, and I always wrote down notices in order to realize afterwards what happened — I think (or at least I had the impression), they were annoyed! As you see, memory gaps are not negative only. But it’s a phenomenon that is hard to explain. In the following I will give it a try (it’s my theory I have about this):

«Dissociative amnesia occurs when a person blocks out certain information, usually associated with a stressful or traumatic event, leaving them unable to remember important personal information.» (WebMD) This means the disease is characterized by retrospectively reported memory gaps. I will give a possible explanation (there exist also others) by using the concept of the “Ego-States Theory” (EST; Watkins & Watkins). Fot those of you, who didn’t read the previous texts, the theory behind EST is the following: the personality splits into its own sub-personalities, so-called ego-states, due to traumatic experiences. These have got their specific characteristics, emotions and behaviors. Initially, they are completely separated from each other. The goal of therapy is to put these puzzle pieces together into one inner team and to improve interaction between them (or at least improve coexistence). DID patients are (initially) not able to integrate the different ego-states to a great whole. In my case, the ego-states were unaware of each other at the beginning. After implementation of writing a diary and consequently reading it in every ego-state, I could achieve that the ego-states know that the others exist. But, they are still “afraid” and don’t interact much (despite the voices I hear). Unchanged, I am “unconscious” in most of them (as I mentioned in earlier posts, only Chantal acts “conscious” — from her perspective) and therefore suffer from memory gaps, which arise because these ego-states are still too separated from each other — tedious! I am pretty convinced that I will be able to form an inner team one day, but not today! It will take time to reach the therapy goals and, perhaps, I even won’t reach them — I’ll do my best!

— Chantal

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Mental and Public Health Enthusiast, Student Research Assistant and DID Patient

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Chantal Ruchti

Chantal Ruchti

Mental and Public Health Enthusiast, Student Research Assistant and DID Patient

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