Illumination FAQs

plus some questions that nobody asked but I can hear people thinking

As I said a few posts ago, this Substack serves multiple purposes: partly it’s a journal where I do the kind of reflective writing that we’re forever assigning to our acupuncture students; partly it’s a billboard for topics like 5NP and the acupocalypse; and partly it’s an internal newsletter for WCA and ORCCA that just happens to be public. This post is in the internal newsletter category. For the last couple of weeks, I’ve been working on systematically telling people in my world that my mental health has become a main event (mostly for me, but to some degree for everybody I work with) and this is my attempt to make sure everybody knows.

Wait, what?

For everyone who missed it the first time around: I received a stigmatized psychiatric diagnosis, OSDD. It’s a chronic complex dissociative disorder that has a lot of overlap with DID, Dissociative Identity Disorder. It’s nothing like the sensationalized version you might see in the movies, but it’s still a big deal. Being treated for it takes a lot of energy.

Are you being oppressed by the Psychiatric Industrial Complex?

Thank you for the concern, but no. This diagnosis is good news for me and a big relief. I’ve had bad experiences with mental health practitioners in the past but what’s happening now is the opposite of that. My type of OSDD happens to be a childhood-onset disorder so I’ve been dealing with the symptoms for my whole life without knowing what they were. Lots of things make sense now, in a way they never have before.

Why so much transparency?

First, I hate stigma and there’s no remedy for it other than transparency. I just came across a great quote about stigma by Saidiya Hartman: “Stigma isn’t an attribute, it’s a relationship; one is normal against another person who is not.” ¹

In the acupuncture profession, community acupuncturists tend to be on the wrong side of “normal” and “respectable”. I don’t want my diagnosis to be weaponized against our school. (And my diagnosis isn’t paranoia — some prominent acupuncturists really are out to get us, lol.) And also, community acupuncturists treat a lot of stigmatized conditions, particularly chronic pain, and I never want to feed a stigma narrative if I can help it.

Second, transparency is better than rumors. This may sound incongruous in relationship to the information I’m sharing, but I’m trying not to freak people out. I don’t want people in my world to worry unduly about what’s happening with me or about the impact on our organizations. And if everybody at WCA and ORCCA gets a crash course in dissociative disorders (DDs), that’s not the worst thing in the world; they’re gravely under-diagnosed and under-treated — some experts argue that they’re a full-blown public health problem.

Third, I don’t have the energy to hide this and it’s not reasonable to ask me to. One of the purposes of our school is to teach students how to accompany all kinds of people, including people with disabilities, chronic conditions, and trauma. If someone doesn’t want to be around me, they probably shouldn’t be attending ORCCA. (If that’s you and you’ve been admitted already, please let us know ASAP — we have a waiting list.)

How could you have a chronic complex dissociative order and not realize it?

I mean, I knew I had PTSD, which has a dissociative subtype. The flashbacks seemed unusually intense and persistent compared to other people I know who have PTSD, but I tried not to think about that, or about some other — more frightening — symptoms. You know how sometimes you wake up and if you’ve slept really deeply, for a moment you might not know where you are? Sometimes I wake up and I don’t know who I am. I get locked out of my identity the way someone else might get locked out of their house. Eventually I always find my keys but those moments where I’m standing on the porch, rummaging through my pockets and thinking oh shit — they weren’t moments that I wanted to focus on.

I put those experiences out of my mind in order to get on with my life, which is what people with DDs tend to do. It’s kind of the point of having a DD in the first place — dissociation allows you to have a life. It’s an extreme response to an extreme situation but ultimately, it’s adaptive.

My PTSD symptoms got worse over the past few years and I initially chalked it up to midlife hormonal changes — which I still think is part of it. Perimenopause often shakes up the ways people inhabit their roles, but in my case the shaking was more like an earthquake, full-rip 9.0. Emphasis on rip. I’ve never been good at multi-tasking — for example, I’ve never actually worked the front desk at WCA because I’m so bad at it. (Acupuncture was perfect for me because it’s such an exercise in one-pointed attention.) In the last couple of years, multi-tasking got harder and I started experiencing moments where I feel unreal to myself. Micro-breaks with reality.

For anyone who’s familiar with vinyl records (no longer a given!) it’s like a needle skipping and the music stopping, or stuttering. If I have to multi-task, the needle skips get more frequent and the breaks in the music last longer. In therapy I realized that I struggle with multi-tasking because I’m already always multi-tasking: on a subconscious level, I have to work to remember who I am. Minute to minute, it requires real effort. It does not come naturally.

A quote from my favorite PubMed article about dissociative disorders:

Naïve views of the developmental origins of DID posit that the child’s psyche—“the personality born into the body”—is “shattered” by trauma, fragmenting the mind, and creating “separate people in one body.” A more developmentally congruent model hypothesizes that overwhelming early trauma, attachment disturbances, and lack of soothing or comfort after trauma prevent the normal development of continuity of the young child’s sense of self across states and contexts.⁶³ This produces multiple senses of self, often in conflict with one another, that differentiate over developmental time. DID is more like a never-assembled psychological jigsaw puzzle, not a shattered mirror. (emphasis mine)

I relate to the image of the never-assembled puzzle. Maybe this speaks to the difference between OSDD and DID, but my most difficult moments aren’t so much about feeling multiple senses of self, but like I’m trapped in blank spaces between the puzzle pieces, where I don’t exist at all. (The technical terms are depersonalization and derealization.) I’ve had experiences like this since I was a teenager, but I didn’t know that there a term for them and it’s “chronic complex dissociative disorder”.

What does this mean on a day to day level, at work?

I’ve always functioned by finding a groove and staying in it, which was mostly subconscious. Again, practicing community acupuncture was perfect for me because it requires such a flow state. (Did you know that technically, flow states are a form of dissociation?) Now that I’m more conscious of what’s happening, it requires much more concentration to find and stay in a groove at work. It’s less automatic. Maybe that will get better with time and with treatment but I don’t know.

For now, though, my concentration is on a strict budget. I have to dole it out in increments and double check that I have enough to get through the rest of the day. If I exceed my capacity the consequences are extraordinarily unpleasant.

What does this mean for WCA and the school?

Oh good, let’s talk about succession planning and leadership development! My favorite subject.

Connecting back to last week’s post — developing a future acupuncture workforce (no matter how small) is a choice. It requires investment. We made the choice and we’ve made the investment, which means that my psychiatric disability represents a challenge for WCA and ORCCA to rise to — but not a crisis. In some ways WCA and ORCCA are like machines, with their infrastructure chugging along, and in some ways they’re like gardens being tended by many different people. What they’re not like is an individual human going to therapy and being exhausted afterwards.

There are parts of my job I can still do while being treated for a dissociative disorder, parts I can’t do, and parts I’m not sure about yet — I’m working on those lists. But unlike a lot of acupuncture organizations, WCA and ORCCA are not identical with their human founders. I have people who are going over those lists with me and making sure that the organizations’ needs are covered. I have people suggesting accommodations for me — like, no meetings longer than an hour.² (Which is something we try to do anyway, but you know, everybody slips).

A number of the adjustments I need are goals we’ve been working toward already, as part of succession planning. Now they have a jolt of urgency attached, which isn’t a bad thing. Stay tuned for a future interview with WCA’s new Executive Director, Haley Merritt. And for anyone who didn’t already know, ORCCA has two other Executive Directors besides me, Jersey Rivers and Sonya Gregg. We make a point of distributing leadership.

In some ways, this situation reminds me of what it was like when we moved ORCCA’s classroom in 2024. It was a big, scary, entrepreneurial leap, and we used it as a series of teachable moments for students about how small business works. The core requirement of entrepreneurship is managing uncertainty.

My limitations represent new uncertainties for our organizations to manage. That’s not something to panic about, it’s just something to deal with. Limitations and surprises are part and parcel of small business, not something you can eliminate if you work extra-hard and do everything right. In our world, a founder with a psychiatric disability is kind of like the acupocalypse — just another thing for WCA and ORCCA to adapt to.

How can we support you?

This is the most frequent question I’ve gotten, particularly from students, and I appreciate it so much.

You can read this Substack regularly, because it helps me enormously if everybody has the same information and I don’t have to answer certain questions over and over. Even more importantly, though, you can be supportive and understanding with the people at WCA and ORCCA who are, one way or another, picking up the work I have to set down. In alphabetical order, those people are: Haley, Jersey, Sara, Skip, and Sonya. A number of other people are impacted, directly and indirectly, but the people on that list are the people on whom extra responsibility has landed — and they already had plenty of their own.

The acupuncture profession is afflicted by a lack of understanding about organizations and particularly, a tendency to take organizations for granted, along with the invisible administrative labor that keeps them alive. Trying to organize acupuncturists isn’t just like herding cats, it’s like herding feral cats.³ They scratch, they bite! ORCCA learned awhile ago that it’s super important to make the school’s administrative labor as visible as possible. That goes double for times when administrative labor is being redistributed.

Mainly, though, I want to reiterate something I’ve learned in small business: if you don’t intentionally imagine a future, you’re unlikely to have one. A major consequence of my diagnosis is that you’re going to see WCA and ORCCA being more intentional than ever about imagining our future. And that’s a good thing.

Bonus question: Does 5NP take the edge off of symptoms of OSDD?

Apparently, yes! Fortunately I live with someone who knows how to do it, so it serves as a great emergency protocol. This makes me feel even more passionate about community members having access to training. There are no medications for DDs, and I wonder how many other people there are out there who struggle with dissociation (diagnosed or not) who could benefit from the relief that 5NP offers.

1. Saidiya Hartman, Wayward Lives, Beautiful Experiments: Intimate Histories of Riotous Black Girls, Troublesome Women, and Queer Radicals (W.W. Norton and Co., 2019), pg 53

2. See also:

3. Thanks to subscriber Michelle Wright for the “feral” description, it’s so accurate!