Code Blue

Zoning out. Blanking out. Dissociating. Checking out. Being out of it. Whatever people call it, we have an ability to do it. A very good, seemingly very well developed, ability to do it.

Having DID obviously means we can dissociate. We can switch between parts/alters, I can dissociate and lose awareness of my thoughts, feelings, and surroundings, and I can zone out.

‘Zoning out’ would be my preferred term. Our old therapist referred to it as ‘blanking out’, and our psychiatrist refers to it as a dissociative stupor or trance state. All of those terms are kind of meaningless.

What does it look like?

Often it happens during therapy sessions. We’ll be discussing something and become emotionally overwhelmed. Often I feel incredibly anxious, sometimes sad or scared, but whatever the emotion – very overwhelmed.

By this point the conversation will stall. My responses become slower, my voice quieter, and I say ‘I don’t know’ repeatedly. I’ve already stepped back from my body without actually choosing to. At this point there’s nothing anyone can do to help me become more responsive.

Usually I’ll be asked to move by whoever I’m with (psychologist, psychiatrist, nurse) and be unable to. My body is frozen, and although I can hear and feel (and see if my eyes are open) I can’t move. Eventually my head tips to the side, the weight of it seeming to drag it towards my shoulder. From there my body can slowly slide sideways, and if I’m in a chair, out of the chair and on to the floor.

During my last hospital admission this happened multiple times. I think I reached an unwelcome personal best of five episodes in three days. I’d discussed the potential of ‘zoning out’ with nursing staff, and my psychiatrist, but the first episode had nursing staff in an absolute panic.

I’d had an intense session with my psychiatrist earlier in the day, and gone back to my room to rest and watch Netflix on my laptop. I set my laptop up on a chair near my bed, pressed play on Netflix, then got comfy in bed. I zoned out. I didn’t mean to, it just happened. I was aware of being unable to move, but lay quietly listening to whatever I was watching on Netflix. My eyes had slid out of focus so I couldn’t see, but could still hear.

I wasn’t concerned. This had happened so many times that I knew the routine. I also knew that, being in bed, I wouldn’t need moving, and nursing staff would know what had happened and leave me be.

Code Blue

That’s not how it worked out though. My nurse came in to my room to say catch up, and found me lying on my stomach, head to the side, eyes open and unfocussed, and completely unresponsive. She panicked, pressed the emergency call button, and her duress alarm, then rolled me onto my side (with the help of a student nurse) whilst every other nurse on the ward ran into my room. I’m not sure what happened next, but a Code Blue (medical emergency) was called. Within a couple of minutes I had ten or more (according to my roommate who was ushered from the room) doctors and nurses in my room, and in the hall outside.

Thankfully someone had called my doctor who suggested they do a set of obs, but assured the nursing staff that it was a dissociative episode, and not a medical emergency. That one episode was the beginning of many more that admission. It was an intense admission working on a lot of overwhelming things from my past.

My ability to zone out to that extent means that, when it comes to the big stuff, inpatient therapy is much safer for me. When I zone out in an outpatient setting it’s a lot more stressful and chaotic. In the past my psychologist has had to call an ambulance because, being as unresponsive as I am, there’s nothing she can do. No one can move me, I’m a dead weight. She’d have other clients to see, and need to go home, and my ‘episodes’ can last up to eight hours.

So the paramedics get called, turn up, and do the tests they need to do. They skilfully move me to the stretcher, and get me into the ambulance. I get taken to the local emergency department. Last time this happened the ED doctor remembered me from a previous episode and knew to do some basic tests, but to then leave me alone. That is why inpatient therapy tends to be much safer for me when I’m working on the more overwhelming things from my past.

 

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