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Dissociation and a Psychiatric Diagnosis




Separation - A Half Life


by Origins Inc

More Than Grief - Not Quite Death

A number of mothers have mentioned the guilt they have felt in not having grieved the loss of their baby at the time of surrender - how they felt a total numbness for years and often decades afterward. As a result it was decided to include a personal non-identifying psychiatric diagnosis (see below) in the hope of helping others understand why this might have occurred, by explaining how a sound mind protects itself from unbearable distress by shutting off from the trauma until a trigger event occurs where the mind is no longer able to repress the event.

For too long adoption separation has been minimised by being referred to at best - as grief and loss, at worse something we are often expected to "get over" and put behind us. Some of us even thought we had - but had we really?

The possible reason many mothers have been unable to speak of their experience is because their experience had become unspeakable i.e. To speak of it is to make it real - and to make it real is to then have to face their loss - something many were unable to do until adoption legislation gave them hope, bringing their as if dead babies back to life and making them real again.

Naturally the length of and depth of dissociation differs from mother to mother depending on 'trigger' events bringing her out of denial i.e. Some mothers do not block out the experience but cannot access their grief until much later, some grieved immediately and then blocked out the whole racking experience for years.

Some mothers blocked out entirely for years or decades - their grief manifesting itself in other forms - at other objects or life events, some remain dissociated even when they have met their adult child and cannot access reality until sometimes years after reunion, (this often results in delayed emotional bonding between mother and child) at least for a time.

For some mothers the pain of their experience and brainwashing is so deep they may never allow themselves to access their own reality and sometimes place vetoes or deny their relationship with their searching child, disclaiming (as was required of them) that their maternal instincts even existed, some spend their lives denying the existence of their child and cannot physically or psychologically fall pregnant again or until a trigger event (eg entitlement) forces them to be no longer able to deny.

For many the combination of sedation, trauma, not seeing the baby etc causes the mind to manifest an unreal quality regarding their experience (the picture never becoming quite clear until or unless some tangible information is acquired to help piece it all together eg obtaining medical records, social work reports, revisiting the unwed mothers home/hospital, speaking to other mothers with the same experience and with whom they can identify etc.

For some the moment of dissociation is upon signing a consent, when their newborn was taken at moment of birth, when the revocation period had expired, when they attempted to reclaim their baby only to be told it was too late.

For others that moment of dissociation occurred much earlier - somewhere after their pregnancy was diagnosed, when they were told the foetus they were carrying was not their baby but already belonged to someone else, that they could not keep their baby.

Also when their condition was seen by others as a problem to be gotten rid of, when all hope was gone as no-one saved them at the eleventh hour after-all. When they were forbidden to see their child and did not know how to ask, or when they asked and were ignored.

Sometimes it was impossible to dissociate and mothers turned to a lifetime of drugs, alcohol, anti-depressants etc to get themselves through, tragically some took the permanent way out.

If your life experience identifies with any aspects of the above, the following psychiatric report may also seem familiar.

...oooOOOooo...


A Psychiatric Diagnosis


For reasons of privacy the mothers name has been replaced with the term - patient

Patient became pregnant during late 1967 when she was just sixteen and in the earliest phase of her psycho-sexual development. Her family were not judgemental and did not overreact. This did not prepare her for what was to happen later. Her father went ahead and arranged a termination and she was only communicated to indirectly by her mother that this was an appropriate course of action to take.

Her father took her for the termination. She was unprepared for all the aspects of the procedure. She got as far as the surgical theatre and being put into stirrups, but was very conflicted about the abortion to come. She became distressed and asked that it not go ahead. When she went downstairs her father accepted that she could not go ahead with the termination.

Patients mother, a gentle and indecisive person, said "there was no turning back now" referring to going on and giving birth. She remembers being taken for an interview and with a social worker and adoption being mentioned. She became upset and the social worker asked that she go outside. When she came back there was no mention of it (adoption) and it was never again discussed.

What followed was a significant aspect of the family's style of communication. They did not discuss what would happen, or talk about any options. On her own part she reacted well to being pregnant; she felt well and in good spirits. At five months of pregnancy she was sent to a Tresillian home for unmarried mothers where she befriended another girl.

Sandra was eighteen and was talking about keeping her baby. She, (the patient) "got it into her head" that she would keep her own baby too, Patient was concerned at the treatment of some of the other girls, particularly one who was going into labour. She got her sister to get her out of there.

At another interview with the social worker at seven months she said she wanted to keep her baby. The social worker talked about babies growing older, and how difficult a six year old would be, taking him to school etc. She then asked, "How would you look after a ten year old?" Patient can remember saying (or thinking) "When he's ten I'll be twenty six".

A position was then found for her with a woman who was pregnant and had a two year old to care for. When she was seven months pregnant her employer brought her new baby home, and patient had a confident role in helping to care for both children. She was not thinking about adoption at all. She said "Nobody said I can't keep my baby".

From her hospital records the birth occurred at 3.56am. At 7.15am she was given 200 mgm of Sodium Pentobarbital, and 20mgrm of the synthetic oestrogen Stilboestrol. She was further dosed with both of these drugs during her hospitalisation. Stilboestrol is a synthetic oestrogen compound, and used in this context to suppress lactation. It indicates a preconceived plan to remove her baby from her. Because she had a pillow on her neck, literally against her face, she was completely prevented from seeing her baby.

She was asleep when the woman from the Child Welfare arrived; patient was affected by barbiturate drugs and highly distressed at being unable to see or hold her baby, but had been sleeping most of the five days since the birth because of the pentobarbital. The woman drew up a chair beside her bed. She had the forms to be signed on a clipboard. Patient said, "I don't want to do this".

While the woman addressed her in a gentle manner, her message was that patient had no prospect of keeping her baby whatever; she indicated that the alternatives were that her baby would be made a state ward if she did not sign the forms. She said words to the affect that "if she loved her baby she would not wish that fate upon him". Patient just cried and was unable to say anything else until a pen was pushed towards her. There was no mention of the word 'adoption'.

The whole message was delivered to her with conviction and authority. Patient said she was told she was "young enough to get over this", or similar words. Patient thought it was not her choice and she would have to do as she was told. She was very afraid. The woman had indicated to her that she did not have the right to make a choice of keeping the baby. She realised this with a great shock.

The woman would not give patient the document or the clipboard but held it for her to sign. When she realised that patient was left-handed she got up on her feet and moved around the bed for her to sign with her left hand. She was pushing the pen at her and patient squeaked out, "I could take the baby home to mums". The whole procedure took about five or six minutes.

It was on signing these forms that patient went into a profound state of Nervous Shock. She has no memory of leaving hospital, only of being home with her family in a state of total emotional numbness where no thought of her pregnancy, labour, delivery or baby entered her mind. While this is well documented on loss of a baby, the circumstances which virtually maintained this state for 22 years are extraordinary.

The family acted and talked as if it had never happened. The dynamic of total denial was pursued until her mother decided to mention it, nearly 23 years later. Once it had established itself, the dissociation of patients memory of a great block in her life was defensive against the anguish and unbearable distress of her loss, and a false personality characterised by numbness, disbelief and automatic collusion with her family's denial mode of relating came into being.

This false self had the persistent characteristics of the primary elements of nervous shock response: spontaneity was lost, the range of emotional life was limited and withdrawal from relationships was the rule, engagement with others was cautious, tentative and characterised by uncertainty and low self-esteem. She avoided anything and everything that might remind her of babies or her experience with Crown Street.

She describes dissociative phenomena authentically. She said from time to time she had sudden and unheralded flashes of conscious thought. She said they were very brief and as if "electric". There was not time for a word or a clear image, but there was a sense of "baby" about them, but they were often experienced as if she blanked out briefly from her normal train of thought. She would get a severe somatic reaction in her gastrointestinal tract when the particular song associated with her earlier life and pregnancy would occur.

During this period of dissociation patient would find herself scouring death columns in newspapers searching for dead babies, finding great relief when one was listed and subsequently weeping inconsolably for "the mother of that dead baby" without identifying her own loss. Patient had found a way to express her own grief without realising that it was her own baby she was searching and grieving for.

Breakthroughs of this total dissociation occurred very briefly when in hospital in 1979: her baby's name 'Craig Anthony' came into mind. Her nephew was born in 1981, and her mother made the comment in front of her that ". . . finally I'm a grandmother". Patients immediate and spontaneous response provided a shock and surprise at herself, because she screamed out "The first one you didn't want!" She was conscious that her face and manner was extraordinary: her face was "horrified. . . mask of grief. . . twisted and ugly". She was consciously mystified at the origins of that outburst and put it back where she did not think about it.

After that she would try to get to this part of herself and it felt vague and difficult to pin down, like trying to remember a dream, although there was now some brief memories of "the child I once had" as she would get little flashes of conscious thought while quietly doing the dishes when on her own.

During the time of public debate over the new adoption laws in 1991 her mother brought around newspapers with circles of red texta on them. She knew they were articles on adoption but she could not look at them.

She received the amended birth certificate in April 1991. She still felt unreal - as if a dream was occurring - afraid it would become chaotic like a dream. Patient spent the next two weeks composing many letters to her sons adoptive parents' - tearing them up and rewriting. When she posted it she became extremely anxious and highly distressed in her anticipation of what might happen. She has literally hardly worked again. She would wait for the post, and go into her business after 1pm, forgetting her obligations.

It is important to realise that this first letter was written from the newly conscious primitive long dissociated part of her personality and I am aware that it was emotional, pleading and essentially distraught. The reply came without compassion; it produced gross depressive decompensation, suicidal preoccupation and despair.

A further crisis occurred at the time of her fortieth birthday: this time in front of her stepfather. She had the sense of 'flipping out of my body' as she screamed at her mother to "give me my baby back" (as if time had stood still). She was vomiting and dry retching. She said it was as if one part of her was seeing what happened and the other part was acting out gross screaming ending up "a heap on the floor". Two days after this incident she wrote to her son. His signature because his capital A's are identical to her own is the first tangible thing for her that he is real or ever existed.

From this period to the present day, she is struggling to integrate and reality test both aspects of her personality and reconcile them. She has essentially a 16-year-old true self. This self is now in the emotional, pining, searching stage, reverting to old nervous shock defences. All this is beside the numb and conforming false self. These of course cannot be reconciled.


Opinion


The process and circumstances of patients son's adoption are the entire cause of a severe psychiatric syndrome which would be classified under a Dissociative Disorder DSMIIIR 300.15. There are features of distinct personality modes, but not of the pattern described under Multiple personality Disorder.

There are features of Psychogenic Amnesia and also major features of Depersonalisation. These, when the protective aspects of their separation have been threatened since the events of 1991, have caused decompensation into 296.3X Major Depression. Dissociative Disorder is mostly precipitated by acute shock loss or trauma.

In this case the lack of any preparation, the drugged state, the lack of rapport or explanation and the authoritarian control heightened the shock. Another view of this is that patient suffered gross nervous shock associated with acute loss and grief, and that the dissociative mechanisms that came into play left her with the loss of her mainstream personality up to the time of the loss.

These two views are only semantic views of each, other using a different conceptual model, and as such are equally valid. The psychopathology (or severe pathological grief according to the model) is an attempted adaptation to unbearable pain and distress. The nature of this mental state would totally preclude her from making any claim, yet it is entirely caused by the matter about which she would make any claim. It would not have been possible for her to have made a claim at any time before she did, and she is only able to do so now with specific personal and professional support.



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