Four terms to define to begin this article:

• Delusion (n.) the firm belief in something (idea, concept, etc.) despite evidence presented that would prove the belief false or otherwise not true
• Dissociation (n.) a commonly seen response to an overwhelming experience, such as a trigger of a trauma, that results in the inability to rationally explain what happened
• Psychosis (n.) a commonly seen response to an overwhelming experience, often associated with mood disturbances or chemical overwhelms, that results in an inability to recognize what is real and what is a perception/idea of the mind
• Cognitive Distortion (n.) something that seems believable but utlimately becomes less plausible when logically reasoned through; a belief that is often emotionally charged but logically fallible and often a result of overwhelming emotional states

The thing is, all of the first three are technically cognitive distortions. And because we forget the first definition of cognitive distortion being that it is just an idea that is well-intended but that plays out illogically or destructively, and sometimes write it off as just a mental health concept, we forget to express these concepts in other areas of life.

I will be bold and upfront: I have dissociative PTSD.

When I get really triggered or get really overwhelmed, my trauma response is to dissociate, and I know that I cannot rationally express a damn thing while in a state of being triggered and overwhelmed. I can’t even rationally percieve things at times. It barely tracks with the outside world how scary it is for me. People say they’re scared of me, but I just don’t see how me worried that I’m being harmed is them in danger? I look like a kindergarden teacher and can barely fight; I am no danger to anyone. Promise.

For me, I can remember things that happened.

And I need a lot of time to rationally explain it.

I can’t be asked in the moment of dissociation to explain what happened.

Unfortunately, the world doesn’t get it. But I can’t explain to everyone I encounter that my triggers are really dumb, and sometimes I get myself in the dumb situations. Like when I go to a Church small group and a very relgious guy shows up. And he reminds me exactly of my abusive ex. I didn’t think that was going to happen, but it sure did. It hurts.

Part of what people miss is the reason I put myself in dumb situations is because I vouch for the mental health community, the clinical community, and the communities of people who have been kicked out of the church for not being perfect enough. Because I will put up the damn fight, and I might trigger myself, but the fight is worth it to know if it’s safe.

My biggest mental health fight is often that it’s medical malpractice to say that schizophrenia is “demonic possession” and refer the person out to a pastor.

It’s an example of a delusional stance of the church based in faith. Because faith can make us blind to reality, just as reality can make us blind to faith. It’s bimodal.

But there was this guy, “Rob” who boldy triggered my anger in saying the harmful thing, “But isn’t that true sometimes?” He may have been earnest. But I think he was mean.

And as much as I tried to say, “Well, that can be true, and that’s often so rare that it misses the point of medicine. And it’s a practice not rooted in evidence and data,” all Rob told me was, “That’s just medical malpractice.” Which is also true of a delusion.

Often faith-based people hear my loud and well-thought-out critiques of damaging faith-based interventions as an attack on faith. It’s funny how they do this to me. I don’t see it that way. To me, these call-outs are holding the church accountable while also raising the question of if they really are following God or if they think they are able to play God.

I don’t think linear.

I process information on multiple tracks all at once.

Everything comes in from all directions and never stops.

The issue has been, for a very long time, I couldn’t remember so much of my adult life. It was spent with a guy who was horrible. And I didn’t talk about it because I not only didn’t know but when I did know, I didn’t have the words. And when I did have the words, I didn’t want to be that girl who was horrifically abused and is still reeling in its effects.

Before I met that guy who abused me, my dream really was to be in ministry. Why? Because I love talking about faith, how to fix things, and getting to know why people are the way they are. I love human connection. One day I realized I would not be accepted in any ministry, because I was an unabashedly unashamed queer woman who loved sex.

So I pivioted. Because I knew the types of churches and organizations I liked I didn’t represent the doctrine and values of. But I knew enough from seeing how big and wide the realm of Christianity was that theology and God are so much bigger than one denomination and one set of body of churches in one area of one country.

I found psychology and clinical counseling. It was my dream. I would get to hear stories of people all day, every day. The pay was so much better than ministry. The benefits were actually existent. The education didn’t harp on “pray about it” and was focused on actual medical and empirical research. There were ethical guidelines. You had supervisors.

The goal of therapy was to help the client cope and be their best self. I adored it. A whole job dedicated to loving people, listening to the things that bother them, letting them know you’re safe to have all the feelings toward, and collaborating with them to find a perhaps next step to coping with how challenging life is and how stressful life can be.

To me, working with the trauma and dissociative and psychotic disorders (as defined above) were so great because not only did I intimately know dissociation, but I have been through psychoanalysis for years for anxiety and have heard pretty much all the cognitive distortions on the planet. It’s goddamn amazing how helpful that has been.

The best part? Clients often would be shocked I wouldn’t try to fight them on the reality of their explanation. Why? Because it doesn’t matter. I don’t exist as a therapist to fight clients on if they should have delusions or misperceptions or whatever. I exist to help them cope with mental disorders and find strategies to exist with symptoms like those.

Clients didn’t like me necessarily because I was super talented or experienced, but really because I didn’t think they needed to hear someone call them crazy for expressing symptoms to me. I took the approach that symptoms deserved to be explored. If they were nothing symptoms, then fine. And if they were issues, then we were working.

People forget that even when we’re delusional or psychotic or dissociative or experiencing cognitive distortions, that our feelings and experiences of being scared or alone are still very real and need to be explored. Maybe they’re not “disordered,” fine, but the reality is, if you are so scared that your trauma response scares you? That’s worth a further discussion in therapy. It’s worth processing through. You deserve that space.

Because even when the brain doesn’t know what perceptions are correct or how to rationalize sensory information, the information still illicts emotional data. And real therapists who are really good (as I want to think I am) understand that the emotional response deserves so much credibility. Because sometimes that’s more frightening.

Some of us think that what is scary to the world is that people with disorders as those defined first in this post are going to outwardly attack or harm. But I challenge that.

Consider this.

What is scary to the world is that people with those disorders are so poorly misunderstood when saying “I’m being harmed” or “I’m scared” that they are seen as potentially agressive rather than at a higher risk for self-harm or suicide. Because the data show that realistically, people with such disorders are more likely to hurt themselves than ever hurt anyone else. And saying otherwise? It’s going against the data.

But how dare we go against the data.

Calling out delusions makes us “hysterical women,” right?

Maybe that’s why clients told me things and were shocked. Not because I was some virtuoso. But maybe because I get what it’s like to be in their shoes and be ridiculed by mental health professionals and other people in my community, as well.

Perhaps the combination of knowing what not to do and recognizing how symptoms are easily described but readily intervened helped very simply. I just think my fight is often to say that my expertise (whatever that means) deserves to be respected by others.

And maybe that’s “delusional,” because the data shows that most management doesn’t respect my expertise. I wrote a whole post about that. And also even when I get management who understands me, there’s some other reason it doesn’t work. But somehow I keep pushing on. Whatever gets in my way seems to motivate me more.

I see all the roadblocks as things to research.

Possible topics to research in mental health/social justice:

• Police brutality and its inefficacy in crisis intervention: Looking at how police interrogation techniques in domestic violence and the court’s acceptance of victim-blaming have created harm to victims and suvivors of violence.
• Trauma informed care and crisis management: Why we need to look at the trauma separate from a diagnosis when assessing if the event was traumatic.
• Pastoral counseling and delusional abusers: The suprising link between abusers and church staff, and the ways that abusers are able to game the system to get away with their abuse and force their victims into further silence.
• Credentialling mental health programs: A need to ensure that we allow only students who are emotionally ready and mature enough to be clinicians to be admitted.
• Defining clinical programming: Why misrepresenting your program as clinical when it isn’t can be damaging to your students, but why it actually is worse for the client.
• A call for crisis intervention and holding abusers accountable: Why the court system of domestic violence therapy is clinically contraindicated and why its unethical.

And there are so many more.

But, to me, every dilemma is just a new paper to write.

My issue is not a struggle to be a victim in. It’s a stance to take to fight for others in. I don’t mind if people are victims. I am fine with it. Some of us really are. And for me, I choose instead to fight the good fight. And so be it if that means I lose sometimes.

I’d rather lose on the right side than win on the wrong one.

XOXO,

Dorothy B.