Adult Separation Anxiety Disorder

I recently ran across information online about Separation Anxiety Disorder, which is a panic/anxiety disorder that afflicts adults.  I was really surprised to read about the variety of symptoms included within the disorder, all of which are related to the core issue: a fear of being alone or abandoned.


Here is the DSM IV criteria for Separation Anxiety Disorder:


A. Developmentally inappropriate and excessive anxiety concerning separation from home or from those to whom the individual is attached, as evidenced by three (or more) of the following: 

1. Recurrent excessive distress when separation from home or major attachment figures occurs or is anticipated. 
2. Persistent and excessive worry about losing, or about possible harm befalling, major attachment figures. 
3. Persistent and excessive worry that an untoward event will lead to separation from a major attachment figure(e.g.; getting lost or being kidnapped). 
4. Persistent reluctance or refusal to go to school or elsewhere because fear of separation.  
5. Persistent and excessively fearful or reluctant to be alone or without major attachment figures at home or without significant adults in other settings. 
6. Persistent reluctance or refusal to go to sleep without being near a major attachment figure or to sleep away from home. 
7. Repeated nightmares involving the theme of separation. 
8. Repeated complaints of physical symptoms (such as headaches, stomach aches, nausea, or vomiting) when separation from major attachment figures occurs or is anticipated. 

B. The duration of the disturbance is at least 4 weeks. 

C. The onset is before age 18 years. 

It's strange how much I identify with this disorder.  Every symptom could have been written specifically about me.  I'm going to outline a little about how this disorder impacts my life. 

I suffer from a fairly frequent fear of being kidnapped and forced to be isolated from my significant other.  I also fear that he will be killed or will be taken away from me through a variety of scenarios (some more peculiar than others).  I'm afraid he will meet someone else and leave me because he will like them more than me or find them more interesting. 

When he has to go anywhere for any reason for any length of time my immediate response is to panic.  A million scenarios run through my head.  He has to go visit his grandma in the nursing home and my brain goes on panic overdrive: he likes his grandma more than me, he'd rather see her than see me, he just wants to get out of the house and be away from me, there might be a cute nurse there and she could be better than me and they could have an affair and maybe he'll never come home at all or maybe his car will wreck and he'll get amnesia, what if I am kidnapped while he's gone and he can't find me?  It's silly and outside of the moment I can identify it as silly, but in the moment the fears feels very real and very valid.  

My separation anxiety also causes me to miss out on doing things I would otherwise enjoy.  I will avoid scheduling things for times when my significant other is at home, even if the overlap is less than an hour.  I can't stand reducing the amount of time we have to spend together by even a few minutes.  If there is a scheduling change for either of us, I panic.  If I feel that he had control over the change and scheduled something during a time when we could have been together I get frustrated and accusatory.  I panic and I behave irrationally.  

Over the last three years, I have spent a total of maybe 15 nights away from my significant other.  Those nights I couldn't sleep.  I laid in bed and cried.  I felt like he had abandoned me.  I felt like he didn't love me anymore and didn't care that we were apart. 

And that brings me to one of the major issues I struggle with.  Because I place such importance on being together, when he does not show signs of separation anxiety when I'm not around I feel betrayed, unloved, undervalued.  By my (flawed) logic: I love him and want to be with him, so I'm devastated when he's not around.  He's not devastated when I'm not around (he's not even bothered!), so how can he love me?  Does he even like me?  Maybe he never wanted to be with me at all!

And this is the trap of Separation Anxiety Disorder.  The more you try to make the person like/love you, the more you push them away and the reason for this is simple: to this other person, there is no issue.  You are fighting a war in your head that doesn't really exist.  It's as simple as that, but it's a damn hard lesson to learn.  The reason he doesn't care when I'm not around is because it doesn't matter to him, not because he doesn't like me or love me or want to spend time with me, but because he does not share my fear that significant people might not return once they leave.  From his perspective, since he knows I will always come back he is fine.  Why shouldn't he be fine?  He is secure in our love and attachment, he has no reason to believe my departure would or could mean anything other than that I have something in my schedule, so he finds something to do on his own and is just as happy as a clam.  When I return home it's as if nothing has even happened, because nothing has happened, separations and reunions are a natural, normal part of life. 

People with Separation Anxiety Disorder have a reason to feel the way that they do, they have a reason to fear abandonment.  Many adults with this disorder were once neglected, abused and abandoned kids.  They were hurt or not protected by the people they trusted.  The important thing to remember is that other people have not had the same experiences and thus do not feel the same way.  Adults who have had healthy relationships (particularly in childhood with their parents) are not afraid of being left alone.  Their fundamental beliefs about the world are different from those of people with separation anxiety.   Accepting and understanding this is the first step at overcoming the disorder. 

Why My Parts Are So Young

I'm constantly mulling things over in my brain and trying to decipher my parts and my past.  Since I have dissociative amnesia, I have very little information of the abuse and my childhood to work with, but recently I realized why all my parts are so young (11 and younger).

I believe the abuse ended at age 9.  I don't know this for sure as I have virtually no memories whatsoever, but I tend to believe this is the case based on a number of factors.  At age 9 we suddenly moved to a new house and I was taken out of school to be home schooled, both with little to no explanation as to my parents' motivation for these decisions.  This was also the age when I began self harming the most (although I had definitely done so many times prior to 9).  In general, 9 stands out in my mind as a significant year for me despite my near complete lack of memories.

What I believe happened is that all childishness was pushed aside during the abuse.  I hid away everything that made me a child and I behaved as an adult.  I took care of myself, took care of my sister, handled my own emotions and I had to be very mature.  I remember thinking a number of times throughout my childhood that I was not really a child, that people just thought I was a child.  I also remember pretending to be more childish so that people would not realize how "weird" I was.  For example, I would pretend to play childish games when adults were in the room and as soon as they left I would play torture and abuse games or just completely dissociate.

So, when I was 9 years old and we moved, a lot of things changed: the abuse ended (though I could be wrong about that), I made friends with the neighbor kids, my sister was 3-4 and needed less constant care and could be more of a playmate, so I was finally given a chance to be a child.  That is not to say that I didn't suffer greatly throughout this time period.  I self harmed on a daily basis, I didn't sleep well, I had nightmares, anxiety, a lot of suffering and difficulty in a lot of ways, but I had a fair amount of time when the young parts could come out and be kids.

When I hit puberty just a month or so after my 12th birthday, these child parts were really shut down.  After just 3 years of experiencing the world as a child, I wasn't a kid anymore, I couldn't be a kid anymore, so I couldn't do kid things or play with kid toys.  There was this expectation that I would be older and so I felt compelled to meet this expectation.  When I didn't meet this expectation I was criticized and ridiculed by my mother.  This resulted in most of the child parts being stuffed down and only allowed out on rare occasions when adults weren't around and the situation was just right.

So as a result of this, I frequently feel a deep unrest at being 21.  Internally, I feel like a child.  I want to play.  I want to cuddle innocently.  I want the things that I didn't have as a child, because I never had a chance for those needs to be fulfilled.

So my parts are all kids, they're 11 or younger.  There seems to be a cluster of parts that slide around between 5-7 and another cluster that are 9-11.  There are also a few outliers that seem extremely young and a few that are hard to attach any age to because they are very guarded or come out very infrequently.

Having all these little kid parts is both very challenging and a lot of fun.  I imagine it's a lot like being transexual.  It's very painful when you are forced to pretend to be something you are not, but those times when you can truly be yourself results in great relief and deep happiness.

My child parts are allowed out now almost whenever they want, which I believe will help them grow up and find peace in the world.  But I don't want to rush them.  They were robbed of most of their childhood, if it takes them 10 or 20 years to have those needs fulfilled, they deserve that.  Forcing them to grow up didn't work in my childhood and it won't work now.  I love, appreciate, and sympathize with these parts.  They are children that never really got to be kids.

Dream: A Strange One

I couldn't think of anything to title this dream that wouldn't be triggering or just bizarre.  Here goes, I dreamt this last night:

TRIGGER WARNING

(For: genitals, sexual acts, bodily fluids) 

There was an older man lounging on a couch and he pulled out his penis, but it was very very tiny, like freakishly small, about the size and thickness of a woman's thumb.  He asked me to give him a hand job and I really didn't want to and I was kind of disturbed and surprised, but he kept insisting, telling me to just touch it a little and he demonstrated how. 

Reluctantly I walked over and touched it.  He almost immediately orgasmed and when he did he ejaculated across the side of my head and over onto my back.  It was warm and I was really bothered by it. 

That's the end of the dream as far as I can remember. 

I find it strange, because the man had a little penis.  I've dreamt about men with freakishly large, frightening penises, but never a little tiny one.  I'm struggling to understand what the meaning of this dream could possibly be. 

The Key to Staying Present and Fighting Dissociation

The last few days have been phenomenal for me.  I've been working really hard at staying present in my mind, body, and emotions and I feel wonderful.  I've heard many times that staying present is the key to healing from dissociation, but none of the exercises for mindfulness ever really worked for me.  I was unable to get any more present no matter what I did.

Over the last few weeks I have discovered the key to staying present and fighting dissociation and it's acceptance.  When you've been falling back on dissociation as a primary coping technique for years, most, or even all of your life, it's very difficult to break out of that habit, because it's uncomfortable.  It's scary to not dissociate.

For me, the key to being able to break out of dissociation was simply acceptance.  It sounds so simple, but it's so much harder than it seems.  I thought I had accepted myself for a long time, but once I truly accepted myself I realized that what I felt before was just an illusion.

So here is a contract that I am subscribing myself to, I urge you to try to do the same.  The only way to feel safe and secure with being present is to accept everything that it entails, so here goes.

Starting now, I vow to put forth my greatest effort towards achieving and/or maintaining acceptance of myself.  This includes, but is not limited to the following acceptances:

• I accept my emotions as necessary, healthy, and valid, even if those feelings are scary, painful, uncomfortable, negative, aggressive or intense.  
• I accept that uncomfortable feelings will pass if I do not hold onto them. 
• I accept my body as my own. 
• I accept the sensations that go along with owning my body, even when they are painful, scary, uncomfortable, or sexual. 
• I accept that negative sensations in my body are normal and will pass. 
• I accept my past, both the things that I remember and the things that I have not yet remembered.  
• I accept that the past was not my fault even if someone told me it was, even if I seemed to enjoy abuse or seemed to be acting of my own free will.  
• I accept that I can have a happy and productive life despite my past. 
• I accept all parts, alters, fragments, and dissociated pieces of myself as a valid and necessary part of my survival. 
• I accept ownership for the experiences and emotions of all parts, alters, fragments, and dissociated pieces of myself. 
• I accept that I will make mistakes and that's okay.  I am doing the best that I can.  If I don't know something or can't do something it is because I was not given the opportunity to learn it. 
• I accept that I am a strong, lovable, beautiful person and no one and nothing can change that. 

Dream: Trapped in a House

For once I had a dream that probably won't be triggering to anyone, but just in case, it does feature some mild violence.

This was a couple of nights ago that I dreamt this and it was a very vivid and beautiful dream, despite horror elements:

I was trapped in a house by some omniscient sort of captor whose voice could occasionally be heard (this voice only captor is a recurrent concept for me) and there were a group of good guys and a huge group of bad guys, who were these strange bluish partially zombie, partially ghost people (another recurrent image). We had to fight them with these huge swords and kill them (also recurrent concept).

Well I fought a huge group of these bluish people that were in a large room that was like an auditorium of some sort.  I could hear people yelling in the adjacent room that it was full of these zombie-ghost children who were having their first communion.  A man from the other room did such a good job fighting the zombie-ghost people that he was rewarded by the omniscient captor.

He had this snow globe, which he opened up and more, larger pieces of snow were added to it and he closed it back up.  It was just a small reward of peace for doing a good job.  he flipped the snow globe over and it began to snow in real life.  Somehow we were within his snow globe, while at the same time he was holding it.

I walked outside to see the snow and it was so beautiful and peaceful.  it was a large field with some trees visible in the far distance and some small long mounds that were very strange sort of hills.  I started walking out into the snow despite the danger, because it seemed so beautiful and peaceful there.

A man was the only other person there and he told me that I shouldn't go, that it was too dangerous, but I wanted to anyway, so I did.

Once I was a good distance into the field these black shapes started becoming clear in the distance.  After a while I could see that they were black cows.  I got scared and started running towards another doorway into the house.  As I was just making it to the doorway one of the black cows bit me on the fingers and I kept pulling and pulling and eventually I got them free and got inside.

I know there was more to the dream before and after this, but that's all I remember now.  It was so strange and vivid.  I'm not sure what it could mean as of yet.

DID 104 - Dissociative Identity Disorder Symptoms

**This is part 4 of an educational blog series I am writing about DID.  It is based on scientific research, my experience, and the experiences of others with DID. To view all posts in the series, click on the tag “educational” on the sidebar.**

Introduction 

This section is not intended to diagnose.  My motivation is to provide a detailed overview of symptoms of DID, which I will break down into smaller, more specific sections.  Everyone experiences DID/DDNOS in their own way.  For this reason, I have found that very detailed lists of symptoms are more beneficial than vague ones.  I have attempted to cover the majority of symptoms in each topic.  Let me know if you think any should be added. 

General Child Abuse Symptoms

These symptoms may be present during adulthood, childhood or both. 

• Inability to trust
• Feeling "worthless", "bad", "defective", or "damaged" 
• Difficulty controlling or regulating emotions
• Extremely compliant or extremely aggressive behavior (sometimes alternating between both) 
• Fear, anxiety, withdrawal 
• Lack of attachment to caregiver
• Regressive behavior - acts younger than biological age 
• Unusually adult behavior - acts with maturity or responsibility beyond what is typical for biological age
• Frequent flinching, jumpiness
• Inappropriate sexual knowledge or behavior 
• Layered clothing, fear of being seen naked
• Urinary tract or yeast infections (in children) 
• Imagining or reenacting (with toys or own body) abuse scenarios
• Stomach aches, nausea, illnesses without a known cause
• Suicide attempts, suicidal ideation
• Feeling that you want to die
• Toilet problems or accidents
• Self harm
• Depression
• Fear of the dark
• Exaggerated startle response
• Attraction to movies, books, media about abuse
• Sleep and eating disorders
• Anxiety
• PTSD
• Flashbacks

Ritual Abuse Symptoms

Many individuals with DID were ritually abused.  These symptoms are common, but not entirely exclusive to ritual abuse.  Note that ritual abuse also includes extreme abuse and torture, which can occur outside of a cult or religion. 

• Extreme distrust
• Feeling "evil" 
• Believing that you cause people to be "bad" or hurt you
• Believing there is something foreign or evil inside of your body
• Feeling that something terrible happened to you as a child, but you have no memory of the experience
• Images, concepts, flashes, or dreams of sexual or physical violence or torture 
• Disposition towards violent thought without the desire to act on it
• Daydreaming or imagining traumatic situations 
• DID/DDNOS 
• Chunks of missing childhood memory or complete lack of childhood memory
• Feeling that loved ones will be tortured, kidnapped, or killed
• Fear that you will be suddenly taken away
• Asking others to hurt or injure you 
• Self harming, especially bizarre self harming 
• Rectal bleeding 
• Scars on body without memory of cause 
• Fear or fixation on/of: knives, Halloween, blood, insects, medical procedures, ritual behavior, religious ceremonies, dolls, death, coffins, electricity, needles, baths or showers, extreme fear of mundane objects
• Extreme reaction to dead animals
• Fear in groups, avoidance of groups
• Fear of being removed from bed at night
• Head banging
• Fear of using the bathroom or refusing to use the bathroom
• Lack of emotional expression 
• Intense shyness, inability to communicate with or relate to peers
• Obsessed or addicted to escape techniques: drugs, alcohol, constant reading or watching movies, daydreaming
• Joint pain, frequent limb dislocation or popping, cracking, etc in joints 

Dissociative Identity Disorder Symptoms

Individuals with DID will have some or all of the following symptoms.  

• Amnesia/memory loss - any or all of the following: very little or no memory of childhood, gaps in childhood memory (not remembering school, home life, your parents, a particular family member, etc), losing periods of time in adulthood (not knowing where you were or what you were doing for minutes, hours, or days). 
• Evidence of having done things you can't remember doing - finding writing or drawings you don't remember producing, items you don't remember buying, the dishes clean without remembering having done them, or being told you said something you can't remember saying. 
• Derealization and depersonalization (will explain in next section) 
• Feeling that you have self states or other personalities with partial, full, or no amnesia of what they do and say.
• Having identifiably different sets of mannerisms, attitudes, beliefs, vocal styles or inflections, or feelings of age. 
• Symptoms of abuse without memories of abuse 
• Difficulty maintaining interest in a hobby, project, or job for more than a few days or weeks at a time
• Absentmindedness, frequently forgetting what you are doing, dropping projects without even realizing you started them.
• Frequent headaches and migraines 
• Sudden experiences of intense emotion (especially anger, fear, and sadness) without a cause
• Auditory hallucinations - hearing voices of alters or voices of abusers 
• Periods where you feel, think, act, and talk like a child 
• Jerks, spasms, or unexplainable seizures 
• Unexplainable body pain
• Feeling like you have two thought processes or that there are two or more people controlling your body or thoughts.
• "Coming to" in conversations you did not know you were having or finding yourself doing things you didn't know you were doing

Derealization and Depersonalization Symptoms 

Derealization and depersonalization are on the dissociative spectrum.  Most people with DID and many people without experience some or many of these symptoms.  All dissociative disorders are caused by severe trauma, almost always during childhood. 

• Feeling empty, soulless, non-human 
• Feeling intoxicated, high, or in an altered state without the use of drugs or alcohol 
• Feeling that your life will be cut short, sense of impending doom
• Extreme fear and worry almost all the time
• Dead eyes or a mile long stare
• Full or partial loss of one or more senses (feeling physically numb, difficulty seeing, etc) 
• Overstimulation - everything is too loud, irritating, painful, etc. 
• Feeling as if you are walking on an uneven plane, each step feels lower or higher than the one before 
• Poor concentration, feeling like you have ADD
• Feeling as if you are going to have a heart attack, seizure, or stroke without having one
• Shaking, hot flashes, difficulty breathing
• Overanalyzing or over observing yourself 
• Feeling as if you are seeing things from too far behind your eyes
• Things appear foggy, blurry, flat, or two dimensional 
• Feeling like you are in a movie or dream
• Feeling or believing that you are invisible 
• Inability to feel joy, excitement, or love 
• Fearing that you will wake up in another reality, that your life is not your true life
• Remembering things in third person
• Disconnection from your body, not feeling like your body is a part of you
• Believing you will feel disconnect forever, despite periods where you are not dissociative
• Feeling paralyzed, unable to move or speak 
• Feeling like someone is speaking for you or that your voice is not yours
• Difficulty balancing, vertigo, dizziness, 
• Feeling as if your physical orientation could suddenly change, gravity could suddenly switch, etc. 
• Nothing feels as if it is yours, your belongings, bedroom, house, etc. feel unreal, foreign, or as if you don't own them
• Feeling like you are running on auto-pilot 
• Having moments of clarity where you suddenly feel more alive or turned on 
• Feeling as if you don't exist when you're alone 

Please leave a comment or email me (elliem.mail@gmail.com) with any questions or comments. 

A Family Affair

This is something that most child abuse survivors can relate to: a crazy, messed up family.  It's been on my mind off and on throughout my healing journey that being "screwed up" seems to be a family affair.  But I guess it's these types of environments that create the proper breeding ground for abuse and dissociation.

Both of my mother's parents were/are dependent on drugs and/or alcohol.  At this point my maternal grandmother has disappeared and no one in my immediate family has heard from her years, so I'm not sure what her standing is with substance dependence.  During my childhood I remember seeing her drunk off her gourd, throwing pill after pill down her throat.  She eventually went to rehab, which seemed to actually do some good.  My maternal grandfather manages to get drunk at every family occasion, falling over or tumbling down stairs, acting like an idiot, the whole deal.  For this reason, I refuse to touch alcohol or drugs of any kind.  I don't want to risk it.

In my extended family, there are several children with severe problems.  Three siblings were severely neglected, one had all their baby teeth rot out of their head, a baby had raw skin in its fat folds from being neglected and never cleaned and he had fetal alcohol syndrome.  They told social services that their parents put cigarettes out on their bodies and hit them and that there was no food in the house, but they were not removed.  The oldest girl (about 5-6 at the time) showed many signs of sexual abuse.

These kids' father's father (confusing I know) was convicted of sexual assault and was accused by one of his daughters of sexually abusing his children, but it was not taken to court.  I was exposed to the three siblings mentioned earlier's father and father's father throughout my childhood on a regular basis.  I don't know if I was abused by them (my memories are hidden from me by dissociation/alters), but it wouldn't surprise me in the least.

Another child in my extended family was put into therapeutic foster care and threatened to kill her family, held knives to their throats, the whole deal, when she was only 8-9 years old.  She also shows signs of sexual abuse and reactive attachment disorder.

My brother has had experiences where he lost time, which were chucked up to unexplained seizures despite the fact that no medical cause was ever found.  My mom frequently jokes about her "other personality" having done or said something.  I'm not sure whether or not this is just a joke or if she's hinting at her own truth (I suspect the later).

Anyway, I could go on and on, but my point is...living in a messed up, screwed up family is challenging and it's something that many child abuse survivor's face.  Having no "safe" family members is extremely stressful and the perfect breeding ground for dissociation.  Families like mine also show the importance of breaking the cycle of abuse.

I guess it makes me sad to not have the normal family experience that other people have.  Even abuse aside, it would have been nice to have a kindly grandmother or have my grandfather teach me to fish or go camping.  Instead, I lived in fear of everyone in my family and spent most of my childhood isolating myself for my own safety.  Sometimes I feel really alone in this even though I know many other abuse survivors feel this way too.