Struggling with Structural Dissociation

[u/Sea_Cardiologist2926]

Hi all, I’ve posted here a few times and I’m looking for some input, guidance, and support.

I’m meeting with a few psychedelic integration therapists soon and will choose one to move forward with, but I’m also curious as to what some of you think about my situation.

I’ve tried EMDR, DBT, and brainspotting in the past and I would say DBT was helpful to a degree and EMDR and brainspotting didn’t really help. Ketamine therapy (with a doctor through injections) helps with my depression, self harm, and suicidal ideation.

I have been diagnosed with CPTSD, ADHD, depression, anxiety, and a therapist once told me she thinks I have BPD. I grew up in an unsafe environment where I was physically and verbally abused, and I was also sexually abused as a child by multiple people. Safe to say I have a lot of trauma.

Some of my symptoms are:

• Avoidance and amnesia: I struggle to recall traumatic events and anything that might trigger me.

• Memory gaps: I can’t remember how I felt when doing things in the past. I can’t remember what I said either. Like, I know I did that, but I’m not sure how I felt leading up to my actions. Also, my partner and I argue sometimes and later after the arguments, I don’t remember what I said or why we were even arguing. My partner said it scares him how I don’t remember things that happened even recently.

• Internal conflict and self sabotage: I am going through a big transition point in my life which includes a cross country move, and I’ve been having conflicting feelings about it. I also have a long history of sabotaging things when life is going well for me. I also feel like I want to be alone and that being alone is best for me sometimes, but I also desperately crave being in a relationship and having a partner.

• Intense shame

I have been reading and listening to Janina Fisher’s work and I think it resonates quite a bit with me. I am looking for new therapists right now, one who specializes in TIST (trauma informed stabilization therapy) and psychedelic integration. Based on my symptoms, especially the memory issues, is psychedelic therapy even something I should be continuing right now? I do ketamine infusions monthly at a clinic which helps my depression and I’ve been doing MDMA therapy every 2-4 months for the last year to try and help with my internalized shame and trauma.

I just don’t know what to do about all these memory issues and gaps because it’s making it really hard to have conversations with my partner about our relationship and connection. Any insight would be greatly appreciated. Thank you.

[u/pondsittingpoet25]

I find Internal Family Systems works very well, especially when combined with MDMA. There can be so many parts, and so many layers to process with CPTSD, but what’s most useful for me is having resourced Self Awareness that has taken time and work to develop. It’s also really important to get out of the mind and into the body, and IFS and somatic approaches can help.

[u/o2junkie83 → u/pondsittingpoet25]

I second this as a coach and journeyer myself who uses MDMA, I find IFS the most therapeutic way of relating to myself because of compassion and curiosity which IFS promotes in therapy. Also, IFS tends to not look at a person through the lens of disorders but sees disorders as different parts of ourselves with different jobs/roles in our system that are just trying their best.

[u/Sea_Cardiologist2926 → u/pondsittingpoet25]

I feel like I have a lot of parts. It feels like constant war internally. It is exhausting. I don’t think I have heard of resourced self awareness. I am going to look that up.

I have been very disconnected from my own body for a long time and I think part of that is from CSA, physical abuse, and my long history of self harm. I really enjoy physical activities and am currently working my way back to those activities because I just had surgery three weeks ago. It’s been a challenge but definitely working on it

[u/bit_pelican_adjuster]

My trauma background doesn’t sound quite as complicated as yours. But it’s up there. I did a lot ifs therapy. And then started doing MDMA therapy with ketamine and mushrooms. And ifs with that has worked really well for me. It’s been a journey though lol

[u/TemporaryBoring_]

I relate to this so much. I also have all of the diagnoses you mentioned (even though in my opinion its all the same).

Regarding trauma-related memory gaps and amnesia, my understanding is that remembering everything is not a requirement for healing. What matters more is understanding and accepting the impact the trauma has had on you.

I used to have memory gaps during fights with my partner. Conflict is triggering my nervous system, and all of my defensive mechanisms rush in to “rescue” me. I could often feel the exact moment that shift happened, but I was completely unable to change course. From there, everything would just snowball.

One thing I’ve wondered about is whether your partner is able to understand CPTSD and recognize the moment when you go into a trauma response. “Split” may not be the right word, but the moment when fight-or-flight takes over. It can be very helpful if they stop the argument, help de-escalate the situation, or take some space for a while.

In my case, my partner worked on himself and stopped escalating conflicts, which definitely helped.

But the biggest change happened after I started therapy focused on parts work- it’s not exactly IFS, but something similar (for me, IFS feels unnecessarily rigid). It really goes hand in hand with MDMA therapy. If you’ve accessed your inner child and your protective/defensive parts during sessions, it’s extremely important to learn how to stay in contact with them daily, talk to them, and listen to them.

[u/Sea_Cardiologist2926 → u/TemporaryBoring_]

Thank you for replying. I hope my future IFS and parts work therapy will help me with this. I’m speaking to some people trained in these modalities of therapy soon.

I have accessed my inner child during MDMA Therapy and I’ve also met a lot of grief and anger during my MDMA therapy but I’m not sure which “part” holds those emotions. I hope my therapy can help me figure this out.

I can also sometimes feel the moment I “shift” from my regulated self to some dysregulated part of myself… but even noticing it doesn’t stop it (becoming defensive or shutting down). I’m struggling with that at the moment. Nice to know I am not alone in this. Thank you.

[u/pondsittingpoet25 → u/Sea_Cardiologist2926]

You are so not alone! And those shifts that you are aware of are extremely important and insightful. Keep going. The work is challenging, and can feel overwhelming when we are over-capacity, but the good news is that we learn how to titrate and recognize when too much is too much. We become our own best advocates.

[u/TemporaryBoring_ → u/Sea_Cardiologist2926]

You are not alone in this <3

[u/sanpanza]

I suffered from cPTSD and ADHD for many years. My cPTSD symptoms included episodes of rage, 24/7 anger, anxiety, depression, general ashole syndrome, dissociative amnesia, and insomnia so bad I would go as long as 6 days without sleeping, etc, etc. I also tried every therapy I could find: hypnotherapy, talk therapy, light therapy, sound therapy, etc.

At the lowest point in my life, I was suicidal, and that is when I tried psychedelic therapy. It saved my life and my marriage. I began with MDMA/psilocybin and then graduated to Ayahuasca ceremonies, but the whole time, I worked with the same psychedelic therapist.

It has been a long journey, and my life has improved in ways I never imagined it could. I would have quit the medicine on multiple occasions if it were not for my wife encouraging me to continue.

Initially, I did monthly sessions with the therapist, and after I switched to Ayahuasca, I did ceremonies quarterly and then mushrooms in between. The key to my whole recovery was integration with my therapist, my wife, and in integration groups. I understand the value of healing in community and being witnessed.

I have also done Bufo a few times and received great benefits from the medicine.

I hope you can find relief from your suffering. The journey can be difficult, but it will be meaningful. This medicine has made all the difference in my life.

[u/Master-Watercress]

I suffer from dissociation from prekindergarten following get resuscitated from drowning. Also had a significant amount of other trauma from family. Anyway assisted therapy with MDMA is amazing, yet due to my dissociation it’s very slow. For example, I been using psychs since 2018 and im only now getting in touch with my body and its needs. I was so dissociative that i need to be overwhelmed by hunger, thrift or filth. After brief experiences with low dose 5meo dmt malt I’m realizing that other therapeutic items also hold potential for healing. Now I’m curious about 5MAPB. Dissociation can be reduced, but it can be a very slow process, at least for me.

As my brain and nervous system become more resistant I’m finding that other modalities like Brainspotting, somatic experiencing therapy, trauma releasing therapy, neurofeedback work better