Being hospitalized for a physical illness or injury can be extremely stressful. No one gets any sleep, the food is often a bit scary, and communicating with your outside providers might be tough to manage.
But too often, you just want some help to get to the bathroom… in time.
If you have DID, asking for help OR accepting the help that is offered can be almost as hard to do as getting through the medical treatments.
Many people with DID find that asking for help while being temporarily in need of assistance is as difficult as the pain or other symptoms that brought them into the hospital.
This struggle to ask for help, accept help, and manage the help you receive isn’t so hard to understand. That doesn’t mean that it is recognized by staff. This is true even if you have disclosed your DID diagnosis, and it is your chart. Do not expect that psychiatric consult to make a difference in this situation. Translating a diagnosis into practical strategies outside of crisis is not a psychiatrist’s specialty.
The source of the challenges can be missed or minimized by inexperienced psychotherapists. This isn’t part of the DSM diagnostic criteria, and it is absent in almost every book on DID treatment.
Finding it hard to ask for help, requiring help for simple and intimate acts, and having difficulty getting prompt and effective assistance create frustration. Wanting to be cared for when in pain or immobilized is also universal. This is what comes to the mind of someone who doesn’t understand DID.
But not everyone hospitalized has a history of being abused and neglected to the degree that adults with DID have experienced in their past.
Here are some of the reasons asking for help in the hospital is so very hard:
- When care was absent or dangerous, being independent is a survival strategy. Loss of independence creates vulnerability. Vulnerability triggers a primal fear.
- When trust in strangers is absent, trusting in a provider can be very difficult but necessary, due to incapacity while hospitalized.
- Needing care can trigger parts whose survival strategy is intense attachment to a stranger. Intense attachments to anyone you really do not know are a recipe for disappointment and abandonment.
- Changing shifts mean that the person who provided good care is never seen again, creating another opportunity to trigger abandonment issues from long ago. Or not so long ago.
- Slow care delivery, or inconsistent/inadequate care delivery reinforces a belief of distrust, unworthiness, or suspicion of malicious intent toward a caregiver. Sometimes this is valid. Often it is hard to know.
How can you ask for help?
If you think that other people would deserve assistance in this situation, then you deserve care too. Parts that say otherwise need to know that “now” is not then, and “these people” are not “those people”. Healthy trust is earned, and can be fractional. Asking for some small act or object, and observing the quality of the response, is a good way to start. Your support person can give their input, helping you to identify good candidates for your trust.
How Can Your System Support You?
You want to be the one requesting and receiving the care unless you are in too much pain, too disoriented, or too dissociated. This builds your system’s confidence in YOU! You can also ask your adult parts with good communication skills to support you. A part that is active at work, at church or shul, or a part that runs meetings would be a good choice. They have a skill set that could be helpful to you. Immediate and “blanket” trust or distrust should be questioned. It is likely to be the influence of parts that operate under old survival methods rather than healthy boundaries and attachments.
Some care really isn’t good care. It isn’t you; it is them.
What can you do then?
- You can think of what you would do if your friend, your child, or your partner were in this situation. Find your wise adult part, and let them be the advocate that you would certainly be for important others in your life.
- Ask the most kind and supportive person around you to give you some assistance. This may not be the person with the most letters after their name, like a doctor. The care aide, or the food service staff person, could be your best advocate in the moment to get what you need.
- Act sooner rather than later. A good plan now is better than a terrific plan later. Letting your pain go up or your frustration fester risks more dissociation and bad outcomes.
Need more information like this?
I wrote a book for you!
“Staying in the Room” has changed the lives and the quality of care for many people with DID! Armed with strategies from the book that are easy to use and don’t require you to bring your therapist to your dentist or doctor’s appointments, it could be the survival manual you need!
Learn how to ask for adaptations that transform the OB/GYN visit. Understand what questions to ask a new doctor to get results. Find out why what you do in between appointments could be more essential to your health than you could imagine.