Book: Understanding and Treating DID- 2011 copyright

Tylas, I'm new to the term "disorganized attachment." Could you possibly explain what this is? Not positive, but my guess is that my DID largely stems from an attachment issue (or lack of attachment). THX!

You have to read this blog then.
http://integratingfeelings.blogspot.com ... ssues.html

It's written my UnmotheredChild. Here on the forum. But she talks a lot about attachment issues.

Shilo

Researchers believe that trauma plus a broken attachment between parent and child, play a big role in the development of DID. We basically have known this. It's not just what was done to us, but who it was done by - our parent or caregiver.

yakusoku wrote:I have inclinations that there may have been some isolated SA when I was young (I could be wrong and there might be more) and I know that I witnessed isolated physical abuse when very young, but the major factors in my DID seem to be chronic, extreme neglect by my mom and repeated early separations from my dad, ultimately resulting in near total abandonment.

Hi Yakusoku
I've read & been told that "extreme neglect" is extremely traumatising for a child and in some ways worse than abuse. So don't underestimate that experience.
Parents / caregivers are a child's whole world and literally their lifeline.
Children can sense very young if their caregiver is unable to protect and nurture them as is needed.

All the best, Zel.

Understanding and Treating DID - A Relational Approach by E. Howell

Intro
How co-conscious patients are varies - that is, the extent to which they have knowledge of and are privy to the thoughts, history and affairs of the other parts varies. Often, the part of the self that is in executive control is unaware of the thoughts and activities of other parts - one way amnesia.

Switching or FULL DISSOCIATION - Different internal identities can be prone to suddenly taking executive charge, in effect pushing the identity that has previously been in charge, out of charge. This generally results in amnesia on the part of the identity that had been push aside for the events that occurred while the other identity was in control.

Partial Dissociation - The influence of dissociative parts below the surface on the part that has executive control at the moment. Such as voices, thoughts, visual images, auditory, somatic, volitional acts, impulses and the withdrawal of perceptions, thoughts and emotions.

Host - The part of the self that usually presents to the world and is in executive control most of the time, is a collection of several parts who pinch hit for each other or when the host is primarily a shell who faces the world while other parts "fill in" as needed. This part often functions as a kind of shell, a front. In accordance with gender, among other things, the presentation of the host may vary.

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Chapter 3
Personality Organization in DID
Female Host - Drained, non-confrontational, depressed, masochistic and submissive part who is most often in executive control along with dissociative rageful and terrified child parts, and so on, who are usually not out in front. It can be energetic, idealizing or cheery while other parts hold grief, terror, rage and depression. Some females host however may be angry, compulsively optimistic or openly guarded. Some patients with DID have parts with names, but other patients parts do not have names. Different parts can take over as host at different periods in a person's life. They may or may not have co-conscious with the preceding usually presenting part. It is frequently noted that the usually presenting part is not the original personality. Actually this part could not be the original because no one has an original personality.

The part most often in executive control is not necessarily only one part and may be comprised of various look-alike versions who may or may not have co-consciousness with each other, and who take over for each other when one of them gets too tired or is unable to deal with the current situation. In some cases, no one individual host is in executive control most of the time because there are so many of them who have ever so slightly different, important roles to play in daily life.

Child Parts- It is important to remember that the patient is an adult, despite the childlike ego-states! These parts are NOT actual children! They are packets of childness retained in a surrounding sea of adult psyche. They are stylized packed of adult psyche. The ages often correspond to the age the child was abused. Some may mature and become older in the treament, as well as in life, and some may stay the same age.

*Page 61 - Often there may be twins, in which one child part is compliant and eager to please and another child part is the evil one. Some child parts hold memories of terror and pain. Some may be must, expressing how they learned they they may not tell anyone, and some may only be able to whisper, indicating their terror of being heard or noticed. Behind some traumatized parts, there are often more traumatized others. Some may not hold traumatic memories but may be able to enjoy the things they did as a kid.

Inner Antagonisms: The Theory of the Structural Dissociation of the Personality
We have talked about ANP and EP but here are more notes

Emotional Parts (EP) - The EP remains fixated in the traumatic experiences, which it often reenacts. It is focused on a narrow range of cues that were relevant to the trauma.

Apparently Normal Parts (ANP) - This leaves a constricted ANP to conduct the business of life. To do so, the ANP MUST avoid the affect and information held by the EP including nightmares, dreams, somnambulism, intrusive thoughts, flashbacks and some somatoform symptoms. The ANP is vigilantly avoident of the information and affect held by the EP. Indeed, it is likely to be partially or totally amnesic for the trauma. It is phobic of the memory of the trauma, of cognitions, emotions, as well sensory memories encoded in the body having to so with the trauma. The topics of trauma may be passively avoided or actively suppressed. In either case, over time, the avoidance is likely to become automatic.

The action systems that correspond to the ANP and EP are:

ANP - action systems devoted to carrying on daily life, such as those concerning reproduction, childrearing, attachment, sociability, exploration and play.

EP - defensive action systems and subsystems devoted to the survival of the individual in conditions of threat. Thus - the EP IS fixated in the action system of defense, such as hypervigilance, fight, fright, freeze and total submission.

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Chapter 7 of
Dissociated Self-States

Core = Host (usually) - Usually has amnesia for a traumatic childhood event, but not always. The more Amnesia the host has, the more trauma memory the alter state holds. When trauma is complex and repeated over and extended portion of the child's life, this process may recur repeatedly, resulting in numerous alter states each containing certain autobiographic memories, skills procedural and general knowledge. These various parts taken separately have major deficits in self-awareness and functions. Dissociated and segregated states of mind are also less likely to be linked because trauma causes a decrease in meta-cognitive and reflective ability.

Third Reality
Dissociative identities exist in a third reality, an inner world that is visualized, heard, felt and experienced as real. The internal worlds contains many subjectivities that experience themselves as separate people. The parts often have different physical images of themselves and of each other. This closed system makes for problems in living, and to the extent that this system is closed, it cannot grow. *Since inner protectors are experienced as real, frightened parts may become highly attached to them.

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Chapter 8

Accurate Diagnosis of DID
A contribution to the difficulties of accurate diagnosis has to do with our diagnostic constructs. There are two primary constructs :
1. Switching/Full Dissociation (DSM places the emphasis on this, however the newer version will allow patient reports.)
2. Intrusions/withdrawals of experience
* There must be amnesia between identity states.

DD-NOS (Almost DID)
Presentation in which there are NOT 2 or more distinct personalty states, or amnesia for important personal info. DID treatment is used for this as well.

Intrusions and Withdrawals, Partial Dissociation
Switching occurs with relatively less frequency and may be less characteristic of DID than the phenomenon of intrusion of other identity states into current experience.
Example: Flashbacks , intrusive thoughts, intrusive emotions and "made" behaviors.

Switching/Full Dissociation: Characterized by amnesia

Partial Dissociation: This includes flashbacks, voices, passive influence, intrusions of dissociated experience. There is either subjectively experienced or objectively observable discontinuity in thoughts, affect or behavior without amnesia for behavior or identity.

Emotion
Generally, the host will not express intense anger. Many, if not most highly dissociative people feel depersonalized and with damped down affect a great deal of the time.

Emotion of the abused child - The host [abused child] perceived the abuse as happening to alter and usually has amnesia for the event.

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A little more on the difference of the ANP and EP from the Original Researchers

At a minimum it can be said that the basic distinction between ANP and EP serves heuristic functions in the study of trauma-related mental disorders. For example, the theory predicts testable neuroendocrine differences between both psychobiological systems, such as more prominent norepinephrine levels in EPs (to the extent that they involve activation of the sympathetic nervous system) compared to ANPs upon exposure to (perceived) threat.

Another example of the heuristic function of the theory relates to the differential responses of ANPs and EPs to trauma memories and masked angry facial expression, as well as their different cortisol levels. Findings suggest that the processing of (perceived) threat by these dissociative parts of the personality diverges from the very early stages of information processing onward; this hypothesis can be tested using functional MRI.

In fact, we currently plan this study. If the hypothesis would be confirmed, the next major question to address is what process controls the rather fundamental reorganization of the brain and mind when the traumatized individual switches from one dissociative part of the personality to another, in particular with respect to alternations between ANP and EP.