ego-states and alters explanation please

Hi, whilst trying to ascertain how deep my levels of dissociation run, i'm having difficulty
finding, or indeed understanding, an explanation of the differences between ego states and alters.

Can anyone help me please?

Um...I wish I knew...if I had the answer to this question, I would be way less confused than I am now.

Alters are dissociated ego states. Everyone has ego states, and many people have some ego states that are relatively dissociated, usually a result of trauma. By definition, in DID the alters are not only dissociated ego states but also they are highly autonomous and powerful, able to take executive control of the body and interact directly with other people. In DID-like DDNOS (type 1), the alters have not been proven to take executive control in this manner. In both DID and DID-like DDNOS, at least some alters hide (or are concealed) behind two- or one-way amnesia barriers. A one-way barrier looks like this: Alter A knows all about Alter B but Alter B is unaware of Alter A. Frequently the host alter, the part of the person that usually interacts with the world, is unaware of or in denial about the existence of any other alters.

Most of us are here on this forum because at some point the barriers in our minds began to dissolve (or were temporarily breached), and we became aware of our internal confusion, and consequently began searching for information and support.

Una+, of course, has explained it very well.

The guy who did my assessment, however, believes that even if I didn't have amnesia for recent events, it is still DID because of how seperate and distinct my alters are from each other. So I would agree the distinction is about executive control but not necessarily executive control with an amnesic element.

Bourbon

bourbon wrote:The guy who did my assessment, however, believes that even if I didn't have amnesia for recent events, it is still DID because of how seperate and distinct my alters are from each other. So I would agree the distinction is about executive control but not necessarily executive control with an amnesic element.

I agree with Bourbon's assessment guy Remy Aquarone, but as defined in DSM-IV DID has both executive control and an amnesic (amnestic) element. It is increasingly common for researchers to group together DID and DID-like DDNOS, because subjectively the differences between these two diagnostic categories are transient. Many people diagnosed with DID-like DDNOS do have intervals when they could be diagnosed with DID.

Among all the dissociative disorders, DID-like DDNOS is the diagnostic category most often used. But by convention NOS (not otherwise specified) categories are supposed to be for uncommon, atypical presentations. That means the DID-like DDNOS needs to be in its own category, either separate from or combined with DID. I am with those who argue it should be combined with DID.

Middle-man, I'm afraid I can't make a formal distinction and Bourbon and Una have done well. I can point you to two books, both autobiographies by men, which seem to describe the two conditions for individuals who dealt with trauma.

Robert Oxnam in A Fractured Mind: My Life with Multiple Personality Disorder is a well-written representation of an outwardly successful man, his discovery of his own alters and his dissociative identity disorder. Since I have DID, I can fully relate to all he writes.

Robert Blackburn Knight in A Man's Recovery from Traumatic Childhood Abuse describes dissociated memory loss in the form of ego states or "subpersonalities." Knight's abuse was particularly cruel and sustained and may be difficult for some to read, however he writes in a very matter-of-fact manner so it's easier to process. His therapist and he refer to his parts as ego states, not alters, though ego states that arose early to hold the trauma. These ego states shift over time, many splitting into two parts of the original ego state as therapy continues. Sometimes the original ego state, undivided, also returns alongside the split parts. He describes everyone's interactions in trance during therapy. There's little or no mention of them taking over in his daily life (executive control) or of their having discussions with him much in his head outside of trance. Knight's "ego states" have different personalities and genders and hold different trauma, but they seem to me slightly different from alters. But there's more in common than not.

For me, these authors describe different points on a possible dissociative disorder spectrum. Both were amnesic until well into their adult life of the early childhood abuse. Comparing the two, I relate less to how Knight's mind dealt with the trauma. I believe Knight might be diagnosed with a type of DDNOS.

I believe a necessary test for someone who hears voices in their heads is to try to engage them. Talk to them and learn who they are. Try very hard to listen as it seems to be an acquired skill for some. Speaking aloud to ask questions, then listening for the answer inside has worked for me. Writing questions works well also. Don't focus on why they are there because if they hold trauma you may not be ready to hear that. If you have alters, the only way you are ever going to become consistently stable over time is to establish consistent communication with them. That's a strong statement but I believe it has general agreement. Complete separation of alters from the host is an effective coping mechanism in childhood, but it is extremely unlikely to create long-term stability in adulthood. If you have true alters, they are simply not going to go away. They will remain there and become triggered in the negative and the host will be affected and may not understand why. Although there may be periods of stability, even long ones, instability will return.

If anyone even thinks they might have one or more alters, I would recommend as strongly as possible that they try to communicate with them. If it turns out they're just tapes running in your head, or different aspects of your thinking, no big deal, nothing lost. If it turns out you don't have alters at all, you've only wasted some time. If you do have alters, you've begun communicating with absolutely valid parts of you that you eventually must communicate with in order to gain mental health.

Thank you for the very clear, informative and well explained replies above.
I think for me to get a firm foundation in understanding this concept, I need to start right
from scratch.

Please forgive my ignorance, but this is new terminology for me.
Can anyone define 'ego states' in relation to regular/ everyday /'normal' functioning please?

Dave.

Una+ wrote:Frequently the host alter, the part of the person that usually interacts with the world, is unaware of or in denial about the existence of any other alters.

Most of us are here on this forum because at some point the barriers in our minds began to dissolve (or were temporarily breached), and we became aware of our internal confusion, and consequently began searching for information and support.

The above words describe my exact situation in a nutshell.
I just need to discover my own truth through knowledge.

middle-man wrote:Can anyone define 'ego states' in relation to regular/ everyday /'normal' functioning please?

Dave, there are some schools of therapy that work with three ego states that seem to be universal: adult, parent, and child. A child ego state holds attitudes, feelings, behaviors, beliefs that we held as children toward our parents. A parent ego state holds reciprocal "stuff" that as children we imagined our parents held toward us. An adult ego state usually is quite detached and separate, independent.

Often, our parent ego states are introjects of the parts of our parents that we experienced as hurtful. Sometimes, as John mentioned, a parent ego state may be little more than a script, a voice that says over and over again something your parent would often say to you such as "You stupid boy!" In a trance, a parental ego state may say far more than that, and may even respond to questions by expressing thoughts and feelings about how the host lives his life. An alter who is an introject of a parent will do all that and more. The alter may initiate conversations internally with the host or externally with other people, and may take action. The host may or may not be aware of what the alter does.

Dave, your experience of suddenly quitting a thread that you a reading then not remembering why you quit it and coming back to try to finish reading it, sounds very dissociative to me. Some part of you is not yet ready for you to know what there is to know. But you will become ready, and you'll be able to read more of the threads here.

These are just a few of the many books about ego states:

Intuition and ego states Eric Berne, 1977
Ego states: theory and therapy John Goodrich Watkins, Helen Huth Watkins 1997
Ego State Therapy Gordon Emmerson, 2008

Una+ wrote:I agree with Bourbon's assessment guy Remy Aquarone, but as defined in DSM-IV DID has both executive control and an amnesic (amnestic) element.

The DID-V though is a tad confusing. It states there needs to be an amnesic element but when I asked Remy about this, he said amnesia for childhood will suffice, and it doesn't have to be amnesia for present day. It seems sufferers and professionals all have a different view about what the DSM-V means showing how great a part interpretation and subjectivity plays in diagnosis.