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Be prepared to address these fears openly and honestly. Man, is it ever powerful. It can take the stress and worry and anxiety in your day and completely flush it from your mind. Being thankful for three things within the past twenty-four hours is an idea I got from Craig Ballantyne, the author of the great article The Perfect Day Formula. A commitment to expressing gratitude dovetails nicely with discipline. We all need to be more disciplined in how we view our lives. It's easy to be blind to the good in them and cynical amid endless bad news and constant comparison. Small things especially can be overlooked in the run of a day. But discipline yourself to express gratitude for three things daily, and your life will improve immeasurably. It takes time to sit and think about these 3 things, but it's time well spent. Sometimes I'll do this while I walk or run, but switching your mindframe from one of fear - we're bombarded with news and images and ideas that make us see things in a fearful light - to one of gratitude is a powerful switch. Were I to describe these cases in their rich complexity, the differences between them would become more apparent. The trick for the master clinician is first to diagnose and treat the disease, so that the patient receives appropriate biomedical treatment, but then to regard it as an artifact of his diagnostic training in the symbolic forms of biomedicine. Technological intervention may ameliorate or even cure the disease but not the illness. To treat illness, the healer must dare to meet the patient in the messy, confusing, always special context of lived experience. Disease is a psychobiological process of copying: it duplicates signs, symptoms, and behaviors. The paradox in human disorder is that out of such universal processes comes something specific to a culture and unique to a person. Surely, Arnie Springer, Wolf Segal, Di Isfahandiarian, and Phillips Bingman share nosophobia and other attributes of hypochondriasis. Yet that very fear of disease is elaborated into the hidden killer, utterly serious worries, Isfahandiarian disease, and the history itself of a death. In much the same way, each person in the context of shared culture creates an original identity out of similar patterns of dress, etiquette, food, aesthetic preference, and (in this instance) disease.

Illness meanings, I submit, illumine the manner in which the transformation of the individual out of the group, the particular out of the general, occurs. Recognize that individual fears may be associated with different ego states, which means there may be a developmental issue involved. Self-Help and Coping Strategies This article is written specifically for the person with DID or another dissociative disorder. If you are a significant person in the life of someone who is dissociative, this article can also help you understand more about the dissociative experience. The call came at 11:00 one night as I was watching a movie with my husband. It was a friend. Hi, it's Jamie. I found a therapist, but can I ask you something? He then went on for almost an hour talking about his fears of probably losing yet another therapist, which would make three. He couldn't understand why therapists kept referring him on when all he wanted was for someone to help him. No matter where you are in life or how life is going, there are things to be grateful for. There are always things to be grateful for, we just have to once again train our minds to focus on the good, the blessings, rather than constantly focusing on the curses that are often blessings in disguise. The Necessary Acquisition of Grit Grit is sticking with your future day in, day out and not just for the week, not just for the month, but for years. Discipline without toughness is useless. Toughness, or grit, is what enables you to persist. Without grit, you're soft. If you're soft, you cannot accomplish anything. And softness has invaded our society, which means that if you're to acquire grit, you have to do it purposefully, with intention, not merely by allowing life to present it to you.

As a man, softness means you cannot lead. Those meanings are both created by and create the transforming dialectic that makes Wolf Segal who he is and Di Isfahandiarian who she is. Arnie Springer's illness experience is redolent of the mainline American cultural themes challenged by cancer: the secular engineering view of the world, the expectation of precise control over the physical environment and the body, the unwillingness to grant that life is inherently risky, the fear of hidden killers in our cells (and in our streets). Phillips Bingman also seems to locate a fearsome Western cultural image: after muscular and lithe youth and the robustness of early middle age pass, we move down the long slope of decline at the bottom of which death awaits us. Aging has become a disease in the contemporary West; Professor Bingman's exquisite yet morbid sensibility is as much a creation of that cultural transformation of normality into abnormality as of personal processes. Wolf's and Di's expressions are more ethnic, and thereby replicate more particular, less generalizable idioms and metaphors. Nonetheless, the process of creating originality out of copying is the same. The physician and family caregivers are situated in the gap between copy and original. There is a great danger when they recognize only the copy. Medical journals and lectures are filled with comments such as the hypochondriacal patient is. I agreed that it must be very frustrating, but also suggested that he might be switching states and not realizing it. Could he be portraying himself in a menacing fashion with which the therapists weren't prepared to deal? If so, it could mean that he had a very angry part that was being self-protective. He thought about my hypothesis, but wasn't very willing to accept it. All I know, he said, is that I was talking to my therapist on the phone and the next thing I knew there was blood all over. I could hear the terror in my friend's voice, but felt helpless to do anything about it. DISSOCIATION AND SWITCHING The internal system of an individual with DID is different for each person, yet very much the same. Switching can be a way of avoiding stress that seems overwhelming.

In fact, dissociation in any form is a type of avoidance. Softness means you won't protect or provide. Softness makes a man useless, literally and figuratively impotent. Grit is simply discipline over the long run. It's persistence. It's pushing through or around setbacks and obstacles without giving up. Grit is necessary. It's endurance to see not only your mission in life through, but to see a well-lived life to its culmination. Forget about the project you're working on and commit to living life well, to improving daily, to living how you'd like to live every day. It has to become who you are not just what you do from time to time. Maybe you've had an intense dream that you allowed to fizzle out when success didn't arrive. But even with what little I have done to sketch personal detail, Arnie Springer, Wolf Segal, Gladys Isfahandiarian, and Phillips Bingman can be appreciated as an odd lot to put under a single rubric. Their irrepressible humanity continues to break through as a celebration of remarkable differences: not just in who they are but in how they live their chronic illness. No diagnostic rubric should be authorized to describe those individuals and their illness experiences one-dimensionally, in a look-alike caricature that is carried over into treating them as if they were the same. The purpose of a diagnostic system, after all, is to guide treatment of a disease through a recognition of patterns. It is not meant to be a perfect representation of types of individuals or a guide to caring for their life problems. It is also the case that the copy should not be denied, the diagnosis jettisoned, lest the disease go untreated. There are similarities in the fears of hypochondriacal patients that can be treated if the fears are properly diagnosed and if the caregivers are educated in what to do. But to provide humane care, healers must not lose sight of what is unique to each patient. The ultimate irony in hypochondriasis is that it reminds us of a tension between the nature of life problems and the professional and family systems that respond to them.

Mastery of the craft of healing--whether by the doctor or by the patient's spouse--like mastery of any other craft, begins with the memorization of rules, copying copies. The habitual use of dissociation or switching as a defense is based not only on perceived threats, but also on an individual's perceived ability to cope. Consequently, as your stress level rises, due to present circumstances or triggers related to past trauma, the key issue becomes whether you believe that you have resources available that will allow you to cope. If, at some level, you do not believe you have adequate resources, or if you are triggered at a physiological level, you may begin to switch internal states. Reprinted with permission from The Post-Traumatic Stress Disorder Sourcearticle. Copyright 2000. The purpose of the avoidance related to dissociation is typically self-protection. One person may believe that he will lose control, or even die, if he allows himself to truly feel. So, when feelings begin to emerge, he dissociates. Another person's stress level rises and she finds herself needing to set some limits, but does not know how. Dissociation is a way to temporarily escape the overwhelming feeling, thoughts of project deadlines, crying babies, or whatever the particular triggers might be. Sometimes it's simply not the right dream. Other times, we don't give the dream the effort and time needed for its realization. I've had many dreams come and go and, to be frank, they didn't always go because they were the wrong dream. They went because I felt entitled to success, and when it didn't come I thought it was the goal that was wrong, when it was my mindset that needed to change. Discipline isn't just something we need in the present, it has to apply to how we pursue everything in life, including how long we pursue things. Practice staying the course. Practice grit. The Devil is in TOMORROW Overcoming procrastination