My Girlfriend Dissociated and Forgot Who I Was | Hacker News Reader

My Girlfriend Dissociated and Forgot Who I Was

vice.com

605 pointssz4kerto194 comments

Whenever I hear about stuff like this, I wonder: Is there anything the failure modes of the human brain allow us to deduce about the software architecture?

Maybe memories are stored in some partitioned database, and one of the partitions is always stuff relating to "my identity", and somehow this partition can get unlinked and temporarily re-linked to a blank one, which is discarded after a few hours.

Hmm, maybe this is actually a feature, not a bug. In ancient times people often had to deal with being abused, enslaved, etc. Maybe being able to blank out really unpleasant experiences helped young slaves tolerate their abuse without becoming totally insane or going the route of suicide or rebellion (assuming the latter's success rate was negligible, rebellion would basically be the same as suicide from the standpoint of evolutionary pressures). Which ultimately helped them survive and reproduce.

Then once the mechanism exists, it can still get triggered naturally in modern humans if they're abused, or artificially by drugs.

Failure modes are almost the best ways to figure it out. H.M. (https://en.wikipedia.org/wiki/Henry_Molaison) is a famous case of what can go wrong with seemingly small areas of architecture.

One thing to keep in mind is that the brain is not an OS, it is more of a FPGA (https://en.wikipedia.org/wiki/Field-programmable_gate_array) that is programmed by experience and life. Memory is very much dissociated all over the brain and in non-intuitive ways. For example the motor cortex deals with voluntary (non-reflexive) movement and is in the cortex near the top of your brain. However, given enough time and practice, these movements become controlled by the cerebellum, that little wrinkly thing hanging onto the back and bottom of your brainstem (https://en.wikipedia.org/wiki/Cerebellum#Learning).

Abuse has a much longer history than just the social ones the we humans experience. Though your description of the mechanisms that may underlie this and the reasoning behind it is cloudy, I would assume that the evolutionary pressure to disassociate mentally is a preserved one throughout evolution. We can see this most memorably with dogs that learn to roll over or become head-shy, this may be a form of the behavior that has been with mammals and manifests itself similarly though not in the same way for each species. Also, our view of slavery is distorted and brutal, Roman slave laws were permissive in the later years of the empire (https://en.wikipedia.org/wiki/Slavery_in_ancient_Rome#Treatm...) and even allowed legal redress of the slave to the master. If we evolved in this system, then most humans had to be slaves from the point of view of genes. This is possible, though not probable.

Hacker News: where a very human story of empathy and healing immediately turns into a discussion of what this can tell us about the brain's computational architecture.

Eh. I mean, I see what you're saying, but it is an interesting line of inquiry, and right up HN's alley.

"Human" includes the drive to figure out how things work and how to fix them when they break.

Let's do both. My dissociative loves would all consider it a win.

That's how problems like this get solved.

I get that, but you gotta think about how it comes across. A bunch of computer nerds treating a mental disorder like a math problem. It's seen as insensitive to dive into the problem like that, without a little acknowledgement of the human side of the equation. That's how it comes across to an outsider reading this.

But don't get me wrong, empathy won't always lead to better treatment. Science will. And we should ask these questions. Although you're comment "that's how problems like this get solved" is too optimistic. HN is not a forum for neurologists. I doubt a bunch of programmers on a comment section are going to to make a breakthrough in understanding this disease.

Empathy won't lead to a discovery, period. This isn't a forum to discuss our feelings about articles like this. The entire point of the 'hacker' culture is about fixing and changing things through action.

1. This is a problem that hacker culture doesn't have the resources to solve. 2. I'm not saying you need to have empathy. I'm saying if your first reaction to mental illness is to turn it into an engineering question, don't be surprised if you come off as insensitive to outsiders.

Perhaps that's why that avenue of discussion was brought up here (and not at a meeting of DID sufferers or with a loved one currently in a dissociative state).

I think that while empathy and support are incredibly important with regard to topics like this, it can also be productive to consider new outlooks or avenues of discussion that may contribute to the greater understanding of the problem.

I think a "hacker" centric discussion forum is an appropriate place to consider possibly novel ways of approaching these sorts of issues precisely because it exists as a place to address problems analytically.

I wouldn't find it appropriate or in good taste to start such a discussion in a DID support group or with a family member who suffered from that disorder but that's the whole point of more "academic" discussion forums. They're a place to talk about things that might be seen as gross or improper in polite conversation but that nevertheless may be useful in tackling the underlying issue.

So, let's only post comments that offend no one?

And here I was thinking that this was one of the most interesting replies to the article, what a pity.

You're free to offend anyone you like. Just don't be surprised when you do.

Well, that is exactly why we come to HN and not Oprah.com.

It most definitely is a feature, not a bug. We all dissociate, but to a much lesser degree. When it happens repeatedly and to extreme degrees of trauma it allows the victim to continue functioning (surviving) without being overwhelmed by the past trauma. It's (somewhat) similar to how ships have compartments that prevent the entire ship from sinking in case of a collision.

Can you give more specific examples of "We all dissociate, but to a much lesser degree". Looks interesting to do more googling on that, but I have no keywords.

Have you ever driven home and when you got there you weren't sure how it happened? You didn't remember driving the entire time. Your hands were at the wheel, but your "mind" was somewhere else.

If it was your home and you recognized it, and the people in it, then that is not relevant here at all.

You're equivocating between the colloquial use of "dissociate" (as in "marathon runners practice dissociation and association") and the clinical term as it is used in this context for a disturbing disorder which has nothing to do with driving a memorized route on "auto pilot".

And, by the way, you'd still hit the brakes if a kid jumped out onto the road chasing a ball. It's just multitasking.

Simliarly, a piano player isn't "dissociating" just because he or she isn't thinking about which finger goes to which key at all times.

The kind of dissociation you may experience driving a car (being on auto-pilot) is definitely not as extreme as DID, but they share the same foundation. This is our current understanding of how it works. If you don't believe me you'll have to take it up with the professionals in the field.

Comparing zoning out with DID is like comparing a hill to a mountain. However, I understand where you're coming from. I don't know how to explain it briefly. The mind works in parallel, way more than we think. So it can focus on two things at once, but "you" may not be part of both at all times. You'd have to let go of the idea that "you" (the person that typed that message) control or are even aware of everything that goes on in your mind. You're just an inhabitant (part) of your mind, and you don't control your mind. (This probably doesn't make much sense; sorry.)

We don't believe you because you haven't shared any sources, not because we disagree with professionals.

Please pick up a neuroscience textbook such as this one : http://www.amazon.com/Principles-Neural-Science-Edition-Kand... (here is the camel camel camel page for price comparison: http://camelcamelcamel.com/Principles-Neural-Science-Edition... )

Much of what you say is correct on the first pass, and is better than that of the typical citizen, however, some important details are missing. It seems like you are actually interested in the subject and would benefit from learning in depth about the subjects.

The mind does indeed work in parallel, but you cannot focus on 2 things at once. I think you are referring to reflexes, which are subtlety different than cerebellar functioning and 'automatic' movements. You are very much in control of your own mind, how else would you define what a mind is? However, you are correct in thinking that certain neural processes are outside of our control and that our mind is conditioned by experience to perceive things in a schema.

Really though, the book I linked is great for you, as it seems you have an interest in the subject and want to learn more.

"You are very much in control of your own mind, how else would you define what a mind is?"

Immediately after I read this I tried to think about it. After only a few seconds I closed my eyes in the fashion we close our eyes when thinking about a concept "hurts" (I am very tired, been on the front of the laptop screen pretty much the whole day). Which led me to consider "tiredness": I can define what it is but I can definitely not control it - it happens or it doesn't. Care to elaborate a bit more on your thought?

The way to figure out that you are your mind and are in control of it is to look at people who cannot do so. Are feelings a part of your mind? Are intrusive thoughts your fault or your brains? When you do something that you do not want to, who is doing that? Is that you?

The mind body problem is not really a problem, we are our bodies and minds at the same time. Any patient with an aphasia or neural defect will tell you they just cannot think in a way that they used to. Stoke victims are the same, or people that grew up mute and deaf and now use sign language. The mind is so very complicated, quite the understatement.

In the end, you are your mind, there can be not other definition, you are the person in it, who it is. Therefore, you are in control, or you lack the control to use it, you are the driver of the car and the car itself.

This is too strong a response. You and nobody else has a 1:1 memory map of an intense experience. It can takes weeks if not months (plural) to remember everything that happened to you in the last month. That is because basically your brain samples space time and segments in in your memory in a non-linear fashion. This is why people have flashbacks. When people recall linear events, they only recal prioritized samples. (eg, highlights, takeaways). It's universally understood that this sampling is also highly biased. That is why we have the concept of "type 2 fun". You can google this but the gist of it is that lots of things that are insufferable during the event form warm and fuzzy memories afterward upon recall. There is also the related case histories of people who compartmentalize basically into a black hole, where the thoughts never come back to consciousness or only after some extraordinary event (therapy, or otherwise). Certain types of trauma survivors fall in to this category.

Clinical use of disassociation is somthing involving this process and its important to understand it as part of a continuum.

If you don't remember events due to not paying attention (being "tuned out") that is simply not the same as not remembering who you are or who your boyfriend is.

In the former case, you don't remember the events because you were neglecting to commit them to memory. In the latter case, you have the memory, but it is temporarily inaccessible --- and comes back.

Memories that you did not form because you were tuned out never come back because they don't exist. For example, you will never recall the words of the bore whom you tuned out at last night's party. You nodded your head but were completely occupied with thinking about something else.

There are (clinically) lots of times people don't pay attention and 'tune things out' due to hyper-viigilance.

That process leads to somewhat fractured long-term memory. Basically your brain starts to use short-term memory for something like l2 cach and starts writing stuff that would have gone first into short-term memory and then archived elswhere with a "bibliography" note, directly into deep memory at 1:1 without any simple summary of the memory.

This is how you get people with intensely detailed memory "stacks" without a fully operational "card-catalog" of what is actually in the libary.

The key point is these steps are somewhat plastic.

> And, by the way, you'd still hit the brakes if a kid jumped out onto the road chasing a ball. It's just multitasking.

It isn't multi-tasking, that's just our autonomic nervous system learning to drive a car and goes further than hitting brakes - driving a car becomes all automatic, with gestures that include switching gears, stopping at red lights and so on. It's the same system that's responsible for breathing - you don't need to remember to breath, right? And it's what we call reflex.

Humans are actually bad at multi-tasking. It's cooperative multitasking at best, requiring expensive context switches, which is really the reason for why many of us can't do software development while talking on the phone or while having other distractions around us. For some reason women seem to be better at multitasking, not sure how that works.

Also, as a funny personal experience ... I'm fully on auto-pilot when I drive, which is why I've found myself several times driving to work on the weekend and my work place wasn't my destination :-)

> Simliarly, a piano player isn't "dissociating" just because he or she isn't thinking about which finger goes to which key at all times.

The piano player example is apples to oranges with driving on auto-pilot example. In the auto-pilot example, you are responding to external stimulus (even without a kid jumping into the road), in the piano player example, he/she is using "muscle memory."

Also, the piano player doesn't get to the end of the piece and forget ever playing the piece.

In improvisation in an ensemble (e.g. jazz), you respond to external stimulus. Also, in improvisation, you can sometimes lose yourself and not even know what your fingers are doing at times. You will not remember exactly what you played even moments later. I sometimes noodle on my guitar while reading.

i have. you have to look at others to confirm you played it right after the fact.

i've also done this with kata in my martial arts class, and while playing tetris.

This is why a lot of cognitive psychologists study abnormal psychology. It's when things break that you can find out what's going on.

I do think being able to blank things out (including times of immense pain) is a feature that increases survival rather than a bug. If you are excessively afraid, your ability to pass on your genes goes down.

>> It's when things break that you can find out what's going on.

Please correct me if I'm wrong, early part of Medical academics is all about studying how a healthy body body works. So that when they start studying the diseases they can learn to distinguish between a disease and a expected behaviour.

So to know if something is an abnormal psychology, you need to first know what is normal.

I'm not an expert but my guess is yes, though normal is harder to define in psychology. Psych 101 was all about how things work. It took a few classes to get into why things break.

like hackers which hunt unwanted trace output or unexpected errors (:

Exactly! The magic is revealed when things go wrong.

This is the most fascinating part of mental illness. And it's a bittersweet thought that as horrible as mental illness is, it might be what allows us to really understand the human mind.

However, making evolutionary arguments for psychological traits is tricky business and while I'm not a professional evolutionary psychologist myself, I think the explanation you gave violates a fundamental principle of evolutionary arguments.

Imagine gene A confers a fitness advantage because it allows a person to better cope with a selection pressure X, and gene B confers an additional fitness advantage against X, but only if gene A is present, and does nothing otherwise. In this (common) case, gene B will not be selected for unless gene A is already universal in the population. Following the same rules, imagine we then get gene C which is dependent on B, then a variant of gene A called A* which is dependent on B and C, and so on. Eventually, if even one gene is removed (either by sexual reproduction with someone who doesn't have it or by mutation), the whole tower falls down and the entire piece of complex biological machinery is broken.

Basically, there's no way for selection pressure X on a significant chunk but not all of the population to produce a piece of complex machinery (read: involving 2+ interdependent genes) in the first place, and it would be broken beyond all repair in all offspring who didn't have both parents with the full genetic instructions. So the idea that "many humans were abused, enslaved, etc." only works if the selection pressure was on everyone and the adaptation is universal in the human population, unless it's attributed to a single mutation.

The rarity of this condition isn't consistent with it being a feature. Seems like a bug to me.

Hope this was helpful!

I think (I'm no neuro-*) that one of the things that make the brain so hard to understand is that a lot of the things that a brain is capable of doing could very well be just a side effect or emergent behavior, instead of something that's actually "architectured" (if that even means something..) or designed to do that.

Maybe that applies here and so only the emergent behavior was disrupted instead of actually a "piece" of the system?

There is a guy who has dedicated his career to this :

https://en.wikipedia.org/wiki/Vilayanur_S._Ramachandran

I just happened to be reading Consciousness and the Social Brain [1] which gives a theory of consciousness as the brain's representation of attention.

One of their points was that if consciousness is just a representation it should be possible for your brain to alternate between representations, much like as happens in multi-stable perception [2], which would explain DID.

[1] https://www.goodreads.com/book/show/17349805-consciousness-a...

[2] https://en.wikipedia.org/wiki/Multistable_perception

Oliver Sacks' books looks at a wide range of failure modes, and what those failure modes mean about the structure of the brain (e.g. The man who mistook his wife for a hat). Brilliant writer, scientist, and seems like an all round good guy.

> Whenever I hear about stuff like this, I wonder: Is there anything the failure modes of the human brain allow us to deduce about the software architecture?

There is a long history of this in Neuropsychology. It's referred to as Double Dissociation [1]. Arguably, this is more about the hardware, but the hardware affects the software ("Brain is the seat of the Mind").

[1] https://en.wikipedia.org/wiki/Dissociation_%28neuropsycholog...

> Whenever I hear about stuff like this, I wonder: Is there anything the failure modes of the human brain allow us to deduce about the software architecture?

Like a fault attack to reveal the inners of human. Brilliant :)

And I want to say yes! I've read about it somewhere: a region of the brain was damaged on some persons, and they would function normally most of the time, except they couldn't understand metaphors. I can't remember where I read this though...

1) Why do you imply this is a 'failure mode'? You're imposing a very rigid perspective by using that term.

2) People are being abused at this very moment, it's not something that has only occurred in 'ancient times'.

You ... get used to it. Familiarity, is, as mentioned, the key - narrating the location and why it should be familiar and when they moved there and ways they can prove it's theirs (e.g. keys fitting the front door) tend to help quite a bit. A dissociated mind still wants to believe it should be where it is and that that makes complete sense, it just doesn't have the data available.

Eventually, with luck, you can get them to remember who you are reasonably quickly, and things get a lot less complicated - having the intelligence to call her ex as a substitute was a brilliant move on the author's part.

This is how it usually goes with my wife:

Wife: (looking at me suspiciously)

Me: "Are you confused?"

Wife: (nods yes)

Me: "Do you know who I am?"

Wife: (shakes head no)

Me: "I am your husband"

Wife: (looks at me, wide-eyed, more suspicious)

Me: "Do you have a headache?"

Wife: "Yes..."

Me: "It's going to be okay. This happens when you get bad headaches. I can give you some medicine. Once your headache gets better you will remember everything"

At that point she will usually trust me and the situation becomes much more manageable. In her case, she suffered abuse as a child, and her absentee incidents are always associated with bad migraines. Once we break the migraine, she improves quickly.

Wouldn't something like polaroids be a good strategy, you know, like in Memento? When she forgets everything, have her grab photos from her bag, one together with every person she trusts, one of her in front of her building, one of her in front of a street sign for her neighbourhood. Also, a pocket mirror if she really forgets who or even what she is.

Disassociating doesn't always work like played out in films or TV, sadly. It's terrifying, and often find it hard to trust what's in front of you. Familiarity is needed, as it acts to ground you, and a key part of this is to feel safe on a number of different levels. Simply having photos alone may not be enough, unless those photos are something you regularly examine and experience.

Grounding is a common method of dealing with anxiety and other mental health issues. The idea of finding your place, finding familiarity, centring yourself. Something you are very used to doing normally and when safe is important, as is having that also associated very strongly with being safe.

For some people, photos will work well for this - they might capture moments with strong association with safety and happiness. Some people may be able to instead use an object, a talisman of sorts.

For others, or for when the disassociation is worse, a single grounding method may not be enough. It's about building the complete story - getting home and watching something familiar. The grounding only happens from weight of evidence.

Finally, there's something you don't hear talked about much. Coming back around from disassociating can be utterly terrifying in it's own right. Both as one tries to return, and after coming back. Having multiple entirely different means to ground helps with this.

Fascinating, thanks for your reply. I can imagine photos to not be enough. For me the association is strongest with scents and noises/music - this gets me back to a memory the fastest. I guess this is similar with this disorder?

What's hard for me to imagine is how this disorder works physically, at least with the primitive model I have on how the brain works. The synaptical connection are still there, otherwise the person would have a permanent memory loss, right? So my guess is it has to do with brain chemistry? If that's the case, couldn't it be medicated?

Everyone is different; scents, music, words, touch, observing the surroundings, listing the colors they see, focusing on breathing, holding a familiar object (like a rock), etc. can all be used -- whatever works.

You can use drugs to help with the symptoms, but you can't "fix" it with drugs. There's nothing physically wrong with a DID patient (although they do tend to suffer from various "side effects" that are linked with the disorder).

As far as how it works physically, we don't know for sure. Yes, the memories are stored and can later be accessed. Part of the problem is that these memories are stored without being processed or are "stored" with a part that is unable to make sense of what happened. So instead of dealing with what happened the patient relives the trauma over and over again. What's interesting is that one part can "share" a memory with another part. When this happens it's like "remembering" something you've never experienced.

Because I'm a computer engineer I naturally tend to look at the brain in terms of how computers work. I hope I'm not being disrespectful, but this thing sounds eerily like memory corruption. I mean like corrupted pointers that lead to a garbage addresses. If it's something like that I can well imagine why it's so difficult to deal with - after all you can't 'reinstall' a person's mind. Maybe in the future, if/when we get more precise model's of someone's thoughts, patients could be trained to not go to these corrupted places in their minds? Say, with some sort of neurological videogame that reassociates the paths towards these memories with something bad, and paths that branch off and don't lead to a corruption with something good? I'm most certainly a fish out of the water here, but I like to throw ideas around and keep sort of a childlike naivety about it, if you don't mind.

Like I said in a previous post, it's not a bug, it's a feature. Think of it like a kernel driver that monitors the currently running application. If it detects that the application would overheat the CPU it swaps it out to disk and runs another one that could handle the situation better. Now, this is a very bad analogy, but at least it should give you the sense that it is a coping mechanism, not a flaw. I'd suggest to avoid comparing the brain to a computer. That analogy would hold you back more than help you.

For the record, I'm completely in agreement with "feature, not a bug". For myself and many people I know, mental health stuff makes more sense when looked at like that, and it also matches up with core concepts of Cogitative Behavioural Therapy. At some point your brain needed certain bits of code to survive, but unfortunately the brain can't be cleanly patched once those times have passed (which is also an awful analogy, but works enough for this).

Imagine if today, someone walked up to you and started telling you who you really were. They even have pictures to prove what they are saying is true. You have no memory of any of it. Are you going to believe them?

My wife has these episodes. Evidence-based and logic-based approaches are very ineffective. If I can convince her to go for a ride in the car, and we drive around the city she has lived in her entire life, and drive by the house she grew up in, schools she went to, and get some food from a drive through she's been to hundreds of times, it will reduce her time-to-return by 24-48 hours usually. We can look through several thick photo albums, and at the end she just shrugs and says, "I don't know who any of these people are".

Interesting thought, but the loss is of context not moments, so it turns out to be a terrible strategy even though your idea is great.

Maybe it wouldn't help so much to get the person back into the 'normal' state. But if I read the article correctly, part of the problem is also that she gets scared and she needs some reassurance that she can trust someone - otherwise both her and her SO could get into significant danger. That's what I mean with the polaroid strategy - at least it should help her to reestablish some trust, so they can get into a more relaxed situation where it's possible to heal? In the article he actually also used the photos hanged up in the apartment to start bringing her back a bit, so at least in their case I think it might help a bit.

Thoughts, words, concepts mostly worked for me.

Depends who they are and how and what they forget.

>> having the intelligence to call her ex as a substitute was a brilliant move on the author's part.

I still don't understand why he didn't have her look for HIM in her phone. Like dude, you know me, look in your phone I'm so-and-so. Look at texts between us. There should be a picture of him too. And why TF was there a picture of her ex in her appartment, but not this guy? This aspect of the story made it seem fake to me, but OK maybe it was very stressful to him and he honestly figured the ex would be more familiar than himself. IDK.

She would have seen that he was in the phone, but she wouldn't have known what to do with that information. In any case, he had her call George because he knew what to do in that situation. I think her remembering George was just fortuitous.

But isn't it a rather frustrating experience "I should remember this. WHY don't I remember this?!?!"

I feel like that a lot. I don't have DID or anything like that, but my memory for experiences and conversations is absolutely abysmal, far, far worse than anybody else's I know. Any question of "Hey, do you remember-" I can usually just cut them off and say 'no'. It's completely frustrating and I don't know why I'm like this.

edit: though I don't cut them off because that would be obnoxious.

> She'd wake up with no memory of what had happened, and wouldn't want to know.

This was probably the most painful part of that whole story. Naturally, I was thinking of my wife and myself as the main characters throughout the whole story, and while it would be incredibly difficult to go through this, it would be harder if she woke up the next morning and didn't want to acknowledge or know about what had happened the night before.

(Unless I'm totally misreading that sentence, and the author is saying something different.)

It's difficult and unpleasant to acknowledge what happened. By doing so they would have to acknowledge and deal with what happened in the past (that caused DID in the first place). Part of therapy is to take them on this road. They're able to cope with reality because they're able to compartmentalize their history. Hearing about it, while necessary, weakens the coping mechanism that helped them survive. So you can imagine why they wouldn't want to hear about it.

And on a far more simple level, disassociating and returning from it is utterly terrifying, and worse still one might know that their loved ones will have also had a very difficult experience

I've seen that "exposure" therapy is often used in the treatment of OCD, another form of anxiety disorder. Patients with OCD often have an anxiety about something and use their quirks and rituals to avoid/ignore the anxiety. To help them cure their rituals, they must actively try to experience the often very extreme anxiety that some situation puts them in. Is the treatment similar in cases of DID?

No, that would be too much for a DID patient and could lead to further splitting (creation of new parts). First step is to teach them to stay grounded, to stay present and not take the easy path and dissociate (i.e. go away). When struggling to stay present someone with DID may exhibit OCD patterns -- scratching, grabbing, fiddling with fingers etc. -- all without realizing. However, when this happens there's usually some level of co-consciousness with a part that is suffering or has OCD. So in this case the OCD behavior would "belong" to that part while some other part is "out" (they'd actually both be "out" at the same time). It's a very complex disorder.

Hmmm, interesting. Thanks for the response.

I dealt with physical illness which caused large amounts of anxiety and stress. If you've recovered from a dehumanizing situation, often you don't want to invite those negative emotions back into your life. You just cross your fingers and hope it doesn't happen again.

>while it would be incredibly difficult to go through this, it would be harder if she woke up the next morning and didn't want to acknowledge or know about what had happened the night before

It's not that bad. Once you go through the exercise a few times, you have strategies that work, and it's about on par with having a sick child, where you might be slightly frustrated that you have to take a day off of work or make other arrangements, but you know the steps to take and get on with the day.

Echoing others, this is very real. I had a girlfriend who did this a few times when we were together for a couple of years, although she never was as bad as this, she for whatever reasons (being brought up early by a couple of loving grandparents?) trusted me. The "parental" role thing is pretty much how it always started, and it ended in exactly the same way, after going to sleep she'd wake up normally and not remember any of it. She did always regress to a previous point in her life, at least at one time associated with a very stressful past event. No drug of any sort associated with it, and I suppose it's good it only happened when at home. There was no obvious trigger.

I'll believe it because I had to be "that person who drives people home after a rave" a few times in my life. There's "I forget my name" drunk, but that's a joke, then there's people who are having a semi-bad trip who literally forget who their friends are. It never got as bad as this fortunately.

Use dissociatives responsibly, be in a familiar environment etc.

I do not agree that having a semi-bad trip makes you forget who your friends are. In fact, I wouldn't call that a semi-bad trip, at all. If someone forgets their friends while tripping (and I assume you mean on acid) they actually, likely, never liked that person enough anyway. Breaking down the barriers and lies is what it does.

I would assume as the poster is talking about raves, they are referencing ketamine or MDMA, and both of these are more than capable of making you forget who you are, let alone who your friends are.

MDMA is not capable of making you forget who your friends are, except maybe in serotonin-syndrome inducing doses.

Primarily it is an empathogenic[1] drug, not a hallucinogen.

[1] http://en.wikipedia.org/wiki/Empathogen-entactogen

MDMA absolutely is. I am well aware that it is not ordinarily associated with hallucinations or disassociation. I can also absolutely say that you do not need a serotonin-syndrome inducing dose to forget who your friends are, who you are, or have no idea why you have are sitting on a bed (your own), or who it belongs to. It can also make you hallucinate and "disappear" into your hallucination for several hours, before you pop back into reality. Finally, and not really disassociation and more hallucination, it can make the faces of your friends morph into other peoples and even appear featureless.

Or so I have heard.

I'm sorry but that is complete bullshit. Granted each drug has a subjective and unique experience due to the nature of your biochemistry, but by and large the experience of MDMA is relatively harmless. [0]

The serotonergic effects are a completely different matter.

[0] https://www.erowid.org/library/books_online/pihkal/pihkal109...

"Or so I have heard."

Someone has misinformed you. Please do your own research. There is absolutely no mention of anything remotely like what you are describing in the wikipedia article: http://en.wikipedia.org/wiki/MDMA

All that from E?

I think you are mixing MDMA and LSD here.

Definitely not.

Unless the usual method of taking LSD is via pill form.

But I hear MDMA does not induce hours of hallucinations either, so perhaps LSD does come in pill form with logos on it.

Test your pills if you're having these kinds of effects from them. Chances are, they're not just MDMA. It happens a lot.

LSD or MDMA are not pills. LSD is a liquid, usually poured on a piece of paper/stamp, and MDMA is a crystal, usually broken into a powder.

when MDMA comes in pill form, it's usually called a roll and contains a number of things in addition to MDMA. Usually some other amphetamines like MDA, and a number of other possibilities.

He mentions dissociatives, like ketamine, not LSD.

Not sure about LSD, but if you eat enough shrooms and you'll definitely dissociate.

I was curious with the difference between schizophrenia and DID, since most mental illnesses overlap tremendously. If anyone has a better source, you're welcome to elaborate:

"Schizophrenia and dissociative identity disorder are often confused, but they are very different.

Schizophrenia is a severe mental illness involving chronic (or recurrent) psychosis, characterized mainly by hearing or seeing things that aren't real (hallucinations) and thinking or believing things with no basis in reality (delusions). Contrary to popular misconceptions, people with schizophrenia do not have multiple personalities. Delusions are the most common psychotic symptom in schizophrenia; hallucinations, particularly hearing voices, are apparent in about half of people with the illness." (http://www.webmd.com/mental-health/dissociative-identity-dis...)

You might think of it like this:

DID: Alice is talking to Bob. At some point in the conversation Bob "dissociates" and is replaced by Charlie. Charlie is in the exact same place as Bob and sees all the things Bob was seeing, but Charlie wasn't here before so no idea where here is, how he got there, or who is talking to him. Alice doesn't know anything's wrong at first but Bob (now Charlie) seems uncomfortable and doesn't know things Bob does, like where they are, how they got there, or who she is. Sometime later the dissociative episode ends and Bob comes back in place of Charlie. Bob has no idea what transpired during the episode because Charlie was there instead, but recognizes Alice and remembers things they had done together.

In this case there is no difference in Bob's or Charlie's ability to perceive the world, nor are either of them perceiving something which Alice could not (barring other conditions). There are no hallucinations or delusions; Bob and Charlie appear to "know" different things, as if they were different people. Of note, Bob and Charlie identify differently but its debatable whether they are (or should be treated as) different persons, hence the change of name.

Schizophrenia: Alice is talking to Bob. Bob is talking to Charlie. Charlie isn't really there, but Bob is either unaware or doesn't mind. Bob's conversation with Charlie may be benign or it may involve plots to take over the world, in either case from Alice's perspective Bob experiencing something which isn't real.

This of course is just a possible scenario for schizophrenia, and if Bob is being treated for schizophrenia he may be better able to control or cope with Charlie. In schizophrenia cases Charlie does not exist to any third party observation; Bob is not identifying as Charlie nor is Charlie an alternate persona. Bob believes he is himself and that Charlie is communicating with him.

Ah. Good explanation.

So that's why my ex didn't remember things. I read about it, but I could never quite put my finger on what the dissociation stuff was.

In my very limited contact with people who were suffering from schizophrenia, it's clear their minds, their ability to think, is broken in some fundamental way. This is indeed completely different, the person can think properly, it's just that some things are gone. If it's like my girlfriend who had it when with me, this woman regressed in time a bit, not so far she forgot that previous boyfriend, but enough to forget the current one. But I wouldn't be surprised if DID can be more nuanced.

Agreed. I've lost three friends over the years to schizophrenia. I knew them all well before, during and after. Their minds are simply broken, their reality is not the same as ours. One believed he was a ninja protecting the world, another saw himself as the hero of a WWIII future, the third wanted to bind his spirit with alligators to grow his spiritual totem. DID sounds very, very different.

How so? Genuinely trying to understand, as DID was formerly characterized as multiple personality disorder, and the way you describe your friends seem like it would fit (i.e. a dissolved idea of identity).

I know 3-4 people with schizophrenia, and none of them displayed the kind of wild delusions you're describing (though I am not discounting them! Don't get me wrong). In my experience schizophrenia manifests itself more like a worse form of anxiety, paranoia and depression mixed together (all my friends are under treatment and medicated).

As I understand it schizophrenia leads you to make unwarranted connections between things, and then the mind tries to give an explanation. There's no dissolved idea of identity in perceiving hidden messages and thinking you're linked with a conspiracy. Everything seems to be tied with logic into a cohesive whole, no weird memory gaps or alternate personalities.

There are different forms of schizophrenia, such as paranoid schizophrenia, catatonic schizophrenia and hebephrenic schizophrenia, in which some or most of the symptoms associated with schizophrenia are not present.

Paranoid schizophrenia is most well-known, and is associated with delusions (such as GP comment outlined).

Schizophrenia in general is associated with severe anxiety and depression, explaining your friends' experiences.

Note that I'm not even close to the remotest possible thing to a doctor, and have no special insight - most of my 'knowledge' about schizophrenia should be treated with caution at best.

There is also schizotypal personality disorder (http://en.wikipedia.org/wiki/Schizotypal_personality_disorde...), which can look a lot like schizophrenia and can occur as a comorbidity to DID or borderline personality disorder.

I had a friend who I thought was borderline, and later suspected to have DID. She sometimes said delusional things like she thought she was an alien, or that Jesus was inside her, or that she was a reincarnated dolphin, etc. Other people told me she would get weird in conversations, a lot like the "react oddly in conversations, not respond, or talk to themselves" description in the Wikipedia article. Stuff that schizophrenic people do.

When I asked about it, she said she realized that it didn't make sense that she was a reincarnated dolphin and that she didn't know why she believed those things. Schizophrenic people don't really have that kind of self-awareness.

like she thought she was an alien, or that Jesus was inside her, or that she was a reincarnated dolphin, etc

Not sure about the aliens, but the other two are promoted by (different) major world religions.

Actually the alien one is promoted by a semi-major North American religion also.

You can think of schizophrenia as a hardware problem and of DID as a software issue (not bug, but maybe mis-configuration?). With high enough trauma (and applied early enough, while the brain is still developing) anybody could develop DID; some are more prone than others of course.

It does not sound all that unlike certain types of Alzheimer's episodes.

In addition to seeing my Grandmother completely forget who I was from one minute to the next, more bizarrely she would time warp and believe she was 16 years old and seemingly remember everything/everyone at that time of her life very accurately. Not until now, granted I was very young then, did I ever realize that at times she may have not known who she was, but sitting here now I am sure she would have experienced that as well.

That's very interesting. Alzheimer's and this kind of disassociation disorder could be affecting the same "pathway" or something. Thanks for this comment!

There was a novel[1] about a woman with DID and a psychologist who tied that to suppressed memories of sexual abuse. I wondered after reading it whether or not it was a thing or just a creative fiction. I found at least one paper [2] which indicates that DID can be a symptom of prior abuse.

[2] http://www.sciencedirect.com/science/article/pii/01452134939... was cited by a

[1] http://www.amazon.com/Blood-Memory-Greg-Iles/dp/1441808183

Note that the concept of 'suppressed memories' is not very well accepted by the psychological community. People can be convinced that they remember something they don't, so it's extremely difficult to tell between a 'suppressed' memory and a false one.

A touching story, props to the author for his measured response -- the experience has to be difficult not to internalise or freak out from.

I wonder if the DID experience is the same as "ego death" as described after ingesting large amounts of psychedelics?

There is a whole class of drugs that induce disassociation, including DXM, PCP, and Ketamine. They are more confusing and disabling than psychedelics like LSD.

Does anyone have an explanation for why she can tell a dissociatve episode is about to happen? It strikes me as really odd.

My wife has epilepsy and has auras or deja vu or other spacey feelings before a seizure. After having seizures, she doesn't really know where she is or what's going on and isn't able to talk at all for at least an hour. I wouldn't be surprised of DID had many similarities to epilepsy, so I would guess this guy's girlfriend gets the same auras, deja vu, or spaciness too.

Same with my ex girlfriend, though her disorientation doesn't last as long. It was scary the first time when she asked me "who are you?" but eventually I got used to and it even had funny aspects. Such as the time when she collapsed on the bedroom floor, me making sure she doesn't hurt herself and when she comes out of it, asks me "What happened?". I tell her "you had a seizure" to which she replies, quite resolutely, "No, I didn't!"

Because there is a self-aware, behavioral component to not just dissociative events, but to most maladaptive psychiatric disorders. This component may be small or large - the fact that we've medicalized the disorder simply says that the overall pattern of behavior is causing severe problems, nothing about cause or self-awareness. The people afflicted with them are not simply normal people who are possessed by a random event, like a lightning strike; Their expectations, moods, and desires play a role in the onset of crises. The temptation is to split their agency, their consciousness and their participation into a boolean and say they either have it or they don't have it, that psychiatric disorders must be entirely out of someone's control before we give them a pass on "But it's their fault" and "Just snap out of it!". But allocating problems this severe to the realm of personal responsibility and purely voluntary deviancy is not very helpful to anyone.

The most infuriating thing about having a family member with a personality disorder, my own dive into ab-psych, is that they can turn it on and off in certain contexts, they can be triggered and they can avoid being triggered, but not in a context where you need them to, where you beg them to. It is a way in which they are acting, an unhealthy coping mechanism and pattern of thinking that colors all their thoughts - but it is not something that they can't control or observe at all, only something that they don't usually control or observe well enough to avoid causing problems. There is no clear line between their disorder and their voluntary behavior and their personality, it is one unified whole.

Do we hate them for that? What's the use? Who does that help?

Before we started medicalizing these things, we relied on public shaming and ostracism to control them until the person's behavior got so out of control they became a danger. While it's a cruel way of doing things that we have wholeheartedly rejected, it was surely at least somewhat effective, because of this voluntary component, because telling yourself "Keep it together" is not a 0% effective treatment technique. The country did not suffer from a 26% mental illness rate in times past, and I think it's foolish to assume this represents pure underreporting. Mental illness at least partially conforms to the outlines of the society which defines it - immigrants to the US find themselves substantially healthier than the US on arrival, but develop statistically average rates of US mental illness over time; Symptoms shift from whatever is recognized in their home country to symptoms more in line with US-recognized disorders.

We have decided, rightly or wrongly, that classifying these things according to an insurance-industry handbook, and doling out pills like candy, and pretending these people have no control whatsoever over their disorder in order to relieve them of social responsibility for it, is the correct approach. While the truth is more complex, I tend to find this more humane than some other national attitudes towards the topic, and I have no better approach to offer.

Edit: The problem is, when you acknowledge that these things are maladaptive and problematic behaviors that someone presently does not control well, rather than some kind of seizure that completely robs one of consciousness... you get people popping up who want to go back to the boolean definition again and deny there's any problem whatsoever, claim that they're doing this for attention and faking it and horrible hoaxers who are sucking the precious fluids from our society... There may be too many douchebags out there for a nuanced view to prevail. I see this post already has one, https://news.ycombinator.com/item?id=9147386 . The problem is the boolean: A 100% controlled premeditated affectation must represent a malicious manipulator, the theory goes, while a 0% controlled mental illness strikes a victim, all victims, like a bus hitting an innocent pedestrian. But the mind isn't so simple, and the onus of personal responsibility is not a cure-all.

"The most infuriating thing about having a family member with a personality disorder, my own dive into ab-psych, is that they can turn it on and off in certain contexts, they can be triggered and they can avoid being triggered, but not in a context where you need them to, where you beg them to. It is a way in which they are acting, an unhealthy coping mechanism and pattern of thinking that colors all their thoughts - but it is not something that they can't control or observe at all, only something that they don't usually control or observe well enough to avoid causing problems. There is no clear line between their disorder and their voluntary behavior and their personality, it is one unified whole."

This is so very true. The member of my family with a clear personality disorder would likely be a criminal if she wasn't able to turn it off or otherwise limit it in various public contexts.

Take an upvote for explaining what I have suspected from observations of myself, friends and family for a few decades. I do not have the ability/skills/education to iterate my suspicions quite so succinctly but I do recognize my weaknesses and know if I consciously mitigate the triggers I can prevail over certain impulses and self-destructive behaviors...which is a far cry from what the author wrote about, but still a correlate, IMO.

(I agree with your long and nuanced post.)

> it was surely at least somewhat effective, because of this voluntary component

No, it was a cruel and inhumane way to treat people. Personality Disorder used to be a diagnosis of exclusion in England - people with PD would be turned away by mental health services because they were seen as untreatable. That left them at the mercy of criminal justice systems.

We don't think Mental Health hospitals are the place for people with PDs. It's clear that prisons are even worse.

Here's just one example, but there are hundreds, thousands, of others. And this is England where we have free mental health care.

http://www.theguardian.com/society/2008/feb/03/prisonsandpro...

For anyone interested in the treatment of personality disorder: The current NICE guidelines are a bit old and are currently being re-worked. "Meeting the Challenge, Making a Difference" is an excellent short document detailing what PD is, how it affects people, what best current practice for treatment should be, and a list of recommended psychological therapies.

http://repository.tavistockandportman.ac.uk/864/

http://www.emergenceplus.org.uk/news-from-emergence/507-meet...

Such rose-colored glasses of the past you have. The handling of the mentally ill in the past was atrocious. Hiding mental illness away is very convenient for society, but it doesn't fix the actual problem.

People who suffer brain trauma often end up with it affecting their personality. It is quite possible that many personality disorders have a physiological basis, one that is not as simple as someone "just stopping their behavior".

Yes, we hid them away, we ostracized them, we caged them, we lobotomized them, we murdered them. I'm not downplaying that by any means.

The physiological and the psychological and the sociological interact to produce psychiatric problems in the forms and rates we see. The fact that we've diagnosed a person with a disorder means that the person is failing to control their condition as well as we desire; It's wishful just-world thinking to believe they have no control whatsoever on the one hand, but on the other hand condemning them for failing to control their condition is needlessly cruel. Some of it is in our head, because the place we exist is in our head. There is still a person living in that head, and they deserve our empathy regardless of why they're behaving the way they're behaving... no matter how much our normal interpersonal script demands culpability of them at times.

We suspend culpability not because "It's the disease doing it, not the person" - the two are not easily separable - but only because culpability has proven not to be effective at enhancing control in the past with this person.

The harsher treatment isn't really what I was talking about. People were often said to be "off" or "crazy", but no one talk about it much. Likely mental disorders were underreported because there was less interest in understanding them and more ostracization of those who were open about it. Classifying mental disorders does not mean we're letting people off the hook.

Like I posted previously, physiological factors with the brain can cause poor emotion and impulse control. Abuse during the developmental stages of the brain could also wire the brain in strange ways that, again, someone may not be able to actually control.

Saying society is "soft" and these people are "weak" doesn't solve anyone's problems.

On the other hand, up until fairly recently in the usa[0], some mentally ill people were held in great regard as faith healers, witches/witchfinders, preachers, etc.

[0] http://books.google.com/books/about/Folklore_from_the_workin...

I feel the same way. It is infuriating how hard it is to determine what is actually going on in the mind of another.

> The country did not suffer from a 26% mental illness rate in times past, and I think it's foolish to assume this represents pure underreporting.

I think it's foolish for you to assume you know this. As our understanding of the brain and human behavior grows it's obvious that we'll detect and diagnose previously unknown and underreported illnesses and disorders, especially with spectrum disorders like Autism and ADHD.

Your argument reminds me a bit of Thomas Szasz's book, The Myth of Mental Illness, which you might be interested in (if you haven't already read it). I don't 100% agree with his overall thesis, and I think your stance may actually be a bit more nuanced than his, but it's an interesting read.

Sometimes one can feel it as a headache or inability to stay present. At other times it can be instant.

Because she's experienced it before and it doesn't happen instantaneously?

Even some of the most fast-acting drugs still have a ramp-up. I'm thinking, IV propofol, if you've experienced it before (and even if it's your first time), you can tell that something is happening.

I wonder whether carrying a photo of you and her, perhaps several photos in different situations with different people from her social circle, would be useful.

Depends on the part/alter. Some have a different image of themselves and wouldn't recognize "themselves" in the picture. Some may think you're trying to trick them.

Hmm, tricky. What about carrying a mirror as well; do folks retain the ability to recognise themselves that way?

Depends on the part. The brain can alter what they see in the mirror. For example if they think they're fat and you show them in the mirror that they're not they still may not believe you. It's a fascinating topic.

Then you could think you're dreaming, or that you're being shown a fake mirror, or that you are in the matrix, or... When your brain is trying to make you believe something, then you will see every prooves and ignore the rest. Some sort of extreme bias confirmation.

I was going to go with "record [edit: on her cellphone] her talking to herself explaining who I am and who she is". I would be really worried about the reaction of a stranger or some security-guard-trying-to-be-a-hero.

I would guess the issue with this is a lack of working short term memory. You could show her but she's not going to retain the information. By the time she saw photos in the story you just read, the worst of her episode had passed and she was returning back to normal. The issue is likely more to do with confusion and not understanding surroundings more than it has to do with not knowing who he is.

Its really not a video for her benefit. I hope it will keep her attention and calm her down, but I really believe there is the possibility of getting shot by some bystander and believe a video on her phone might calm the situation an allow people time to think.

Possibly, if she even remembers what she looks like enough to place her in the photo next to you. Otherwise you're just showing her a photo of two random people.

She should record a video of herself reminding herself so she doesn't have to rely on George.

Would she recognise that it was her in the video?

If she can remember George, she can recognize herself. Otherwise, George wouldn't work either, anyways.

This has happened to me with two different people. Both times my face apparently transformed into the face of the person's father - while we were sleeping together. Only one of the times was after the person smoked pot. It was scary to say the least, and scarier when the first one ran to the kitchen and grabbed a chef's knife.

Life lesson: before you get in a relationship, ask about any history of mental disorder or medications being taken. Some people don't tell you about these things until they happen.

That is closer to PTSD than dissociating. Long story short, it sounds like a flashback, and feels precisely like the trauma is happening again. They can last anywhere from a few seconds to a longer period of time.

You're right. It just feels like a similar scenario, and (contrary to other posters' insistence) neither is faked nor dependent on drug use. As the guy in the scenario it's also the same things going through your mind; dangerous for both parties, no good solutions.

Not really a mental disorder, but an uncle was a sleepwalker, nothing scary, except he was in the military; and sometimes, he'd reenact war scenes, some times he'd take people for allies, some times not. It never ended badly, but it could have.

I had a high school friend who I strongly suspect suffered from either schizophrenia or DID. There were times when he would swear he was a soldier, even though he was just a high school student and the closest he came to marching was in band. At first I'd pass it off as a joke or prank, but one day I took a really good look at his eyes when he started wigging out, and it was like seeing a stranger. It sounds crazy but it was a different personality behind those eyes. When he would come back down from it to his normal personality, you could see the change in his expressions. He also claimed he didn't recall his thoughts or actions while he was "the soldier".

Years later, long after we had drifted apart as friends, I found out he murdered his father and tried to kill his mother and brother as well, and went to prison for life.

A second cousin , as a child , her father had cancer at the time, he awoke one night and his little girl was just about to stab him with a big kitchen knife, apparently based on what the family said , his little daughter had no recollection of the drama the night before, she became a totally normal adult with no mental problems.

Wow, such an amazing read!

> A few hours after she first told me, I took some time to read up on dissociative identity disorder.

Shouldn't he have read up on DID in detail when she first told him about rather than when the episode happened? Seeing this mid-way through the event makes it seem like he didn't really do his homework beforehand.

> at its worst, she said, she would not only struggle to identify who she was, but even what she was; unable to process the concept of her own humanity.

This is a really interesting state to study; not knowing your own humanity. Are there any good references to DID that one without prior knowledge can read?

EDIT: Thanks everyone for clarifying. I'm not sure why the down votes though, it was genuine confusion.

I think he meant first told him, that Christmas morning. He's just using that as a lead-in to discussing some specifics of the illness at a later point in the story.

I believe that, "A few hours after she first told me", refers to the conversation around Christmas, 4 months before the DID episode occurred.

Downvoting doesn't always mean you did anything wrong, it can mean you have incorrect information and the comment being gray is there to warn people.

A comment should suffice in that case, shouldn't it?

Comments are fine but take much longer.

Regarding your first point, judging from the "after she first told me" part, I think he did. Though i agree, it was weird to jump in time like that.

I think it takes a strong person to be able to handle a situation like this. I would like to think I could be this strong if my fiancee suffered from the same condition, but I think I would find it too heartbreaking to be temporarily forgotten like this.

The part about his girlfriend calling her ex at his requst was a courageous act from her current boyfriend. It must be hard knowing that your girlfriend in her dissoaciate state can forget you, but remember her ex boyfriend enough to trust him. That would be so hard for many people to handle.

A really great story. It is great to see a story hit the front-page that isn't neccesarily about programming (not in the software sense).

Being late in the discussion, I wondered how many times in the thread the word "unconscious" had been used. Well, it came back as "zero". This, I think, reflects what happened to psychology/psychiatry over the past, say, 30 years and at least in the US: the generalization of an homomorphism between the brain and the current state of data computing. Although a very useful concept, the "unconscious" has been dropped because it doesn't fit in this morphism. Or does it? Low level processes are somewhat "unconscious" to computer operation. There are memory leaks and odd stuff happening with memory blocks that one could see as the expression of an unconscious. But, as some people pointed out, this aspect is only a sort of malfunction of the system. The beauty of the unconscious in the brain is that it is productive. Strictly whatever it does serves a purpose: it can be protective (as in dissociation to tolerate trauma), it can be optimizing (as in handling survival functions in the background), it can be productive (by constantly scanning its database and I/O for patterns, convergences, anomalies, etc.) and, I believe, it is the very source of creativity. To the point that I wonder if data computing might not benefit from emulating such a sub-architecture... As people pointed out, we all dissociate, somehow, in our days and that’s because we have an unconscious that does all that. It has been a huge loss for psychology to lose the unconscious to the data computing model. And it might be a huge loss for data computing to not try to emulate our unconscious.

What I don't get - if this girlfriend could remember an ex-boyfriend, why couldn't she remember she had DID? And, if I could remember I had DID, I would probably have coping mechanisms for dealing with complete strangers who indicated they where my close intimates, and coping with physically being in places that I did not remember. Think about Memento, and the person who couldn't form new memories, but had a number of devices/systems for letting him know who he could, and could not trust.

On the flipside, if I couldn't remember I had DID, and all of a sudden a stranger appeared in my room, and said, "Gordon, you are having an episode. Please check your wallet to remind you that we are close, and call your mother to confirm." - I'm pretty certain that as long as the person stayed calm, and physically away from me, I would adjust to this new reality pretty quickly.

Trying to physically restrain me though, as the author did in this story, would probably be a very bad approach towards de-escalating my freak out.

Real life is not a film. We're talking about a disorder that's likely caused by a traumatic event and is associated with _proper bad_ anxiety. You don't necessarily respond to logic in those cases, you respond to things to which you have a strong emotional response -- and which will, hopefully, comfort you.

Reversely, when you see someone in that state rushing for the door, knowing they'd be helpless to deal with actual risks, 'de-escalating' is the least of your concerns. "I must keep her safe, with me" is the only thing in your mind.

This is an interesting story and if I were a psychiatrist I would be fascinated to study how consciousness can be separated from the ego. In addition, props to the writer; call me selfish all you want but I could absolutely never love someone in a romantic way who had this kind of issue.

They say that you can't choose who you love. I'd suggest that whether to love them wouldn't be an option. You might fall in love, later learn about your SO's diagnosis, and decide you wanted to change yourself to continue to be with them.

However, knowing that you're not personally equipped to deal with these things and that the "object of your affection" might be better off without you is a certain kind of wisdom.

Exactly, I think I might continue to love that person but I don't think I would be equipped to deal with an event such as the author described and then continue to be "sexually" attracted to them. (not sure that term quite captures it but you get the point)

I like imperfect stuff. It has more character.

I can't really see how finding a flaw in a person could change my attraction to them (particularly sexually, though I know you said that wasn't exactly what you meant). Especially this flaw--it's not a moral failing. Moral failings are, indeed, distasteful.

If it's 3 hours per year, I can certainly handle that to be in love.

First you love the person, THEN they have this thing happen, THEN you keep on loving them in spite of it. Like everyone else you love. Or maybe you didn't love them enough in the first place.

That is an incredibly moving story, and it's wonderful how well it turned out. But the author acted irresponsibly. As soon as he realized that his friend was dissociating, in the taxi, he should have called 911/999/whatever and informed the driver of the situation. If this had been a stroke or heart attack, that would have been the obvious move. Why not for dissociation?

The girlfriend gave him very specific instructions about what to do if/when it happened, and reinforced them just before it happened with "Promise me that whatever happens, you will not let go".

I cannot imagine any scenario in which involving the authorities would have improved the situation and not violated her instructions, which he implicitly if not explicitly had agreed to follow. Most specifically "not let go", and getting her back to familiar surroundings, which per the account and others' accounts is important in stabilizing these events when they go that far.

The situation could have gone to hell, and one or both of them could have been injured or killed. Given that risk, his friend's "instructions" were plainly unworkable. If she had run in front of a car and been killed, for example, her estate might have come after him.

If she doesn't want the authorities to be involved, he would need at least a medical power of attorney. And even that would not not protect him from police responding to an apparent abduction. The only strategy to prevent that is to involve them from the start.

What would the cops or an ambulance do in this situation?

At worst, take her away from anything familiar, which we've been told by others is not likely to improve the situation (my personal experiences here already started at home, so I can't comment except that my intuition is that this would be very bad).

Actually, no, anyone who pays attention knows that the worst case is one or both being maimed or killed by the police. Therefore only invoke them if it's really life or death, as the situation would have been he'd disobeyed the "never let go" charge she left him with. As the police would have almost certainly forced after being called, that is, calling 911 would have almost certainly resulted in a deep betrayal of her, and should result in her side ending the relationship if/when she was back to normal.

I searched this thread and didn't find any reference to "Internal Family Systems" therapy. If anyone has any thoughts on IFS, I'd be interested in hearing them. I'm currently reading a book ("Internal Family Systems Therapy" by Richard Schwartz.

Additional info here:

http://www.selfleadership.org/

When I was experimenting with polyphasic sleep there was a moment of around 30 seconds while waking up where I was conscious and aware but not knowing who I was or where I was until I figured out I was lying in the gras instead of standing somewhere. Them I wondered how I'd gotten there and my memories returned.

I used to experience same things after I lose consciousness (happened a lot when I was a teenager). I remember one case, when upon gaining consciousness I was pondering for a whole minute what kind of strange metal columns I see on a horizon. After what felt like a mountain of memories falling onto me, I realized that I'm lying on a floor of a lecture hall, and these columns are just chair legs.

Online, I've met people with a different form of the same condition, or maybe a related condition: they seem to have multiple persons in their head, and will occasionally switch between them. Like many mental health issues it's difficult for me to think about because I have no frame of reference.

> "I know you," she said. "I love you." It meant a lot to hear those words.

Was this moment as sweet as that when you hear the words from someone you love for the first time? The anxiety of "will she remember that she loves me" ending at "I love you" must be amazing.

> Was this moment as sweet as that when you hear the words from someone you love for the first time?

I can only speak for me, and only hypothetically: It would mean much much more in that moment. Someone you love for a long time, maybe your wife, finally remembers you. Sure, its awesome to hear I love you for the first time.

Imagine you fuck up big. Really big. She still talks to you, but every time you do, you notice she's still pissed. Not just a bit, but very pissed, angry, and disappointed. She hasnt said "I love you" in a few days, since you fucked up. And then you hear them again. Suddenly, unexpected.

The world isnt grey anymore. Its finally coloured again.

Very touching. I wish more resources were committed to understanding and solving problems of the mind.

I thought dissociation was part of the symptoms of PTSD. Given the history of being abused as told in the article, I am bit perplexed why doctors decide it was DID.

Or is DID some kind of subset of PTSD?

It is often difficult to get a diagnosis of PTSD when you've not been at war or subjected to a singular catastrophic event. And even if you did, there may not exist treatment pathways for those with PTSD from more complex or long lasting situations :(

It's all on a spectrum with DID being a more "serious/complex" form of PTSD. A DID patient experiences PTSD symptoms, but also symptoms you won't find in PTSD patients.

Is anyone else wondering what movie they were watching?

I will watch Disney movies with my wife who has epilepsy and suffers from not knowing where she is or what's going on after a seizure. She's seen them all a ton, for the first time a long time ago, and they're easy to follow and non-stressful. They're also distracting enough she won't keep realizing she just had a seizure and burst into tears (and then forgetting again 5 minutes later and repeating the process).

You think it could be linked to her DID episode?

Reply on news.ycombinator.com