Trigger: Categories - Ego States or Alters

Bad night last night - My suicides, Sybil et al, were stirring, but finally awake and going to read it.

Before I read it I do want to explain some things since everyone can't just read my mind and understand me?

IMHO: Triggers - Categories Galore!

I know I have black and white thinking to a great extent - as do many with DID even though we fight it.

I know I refuse to belong to any group - I am a rebel. I was taught to be this way as a child - the family group was not safe. I am not political. I am not religious. Even things I get very involved with like dance and martial arts - I stay outside the group. So - you won't find me agreeing with anyone that I do not feel is right. I wonder if this is why many of you are so against experts - but mostly I think it's your definition of what an expert is verses mine. I do not agree with all those (actually with most) that write or study DID. When I say experts, I mean: E. Howell, K. Steele, van Der Hart and others of that extreme caliber that have worked with many DID and DDNOS patients and for so many reasons - really do KNOW their stuff!

Boopsy - JJ: My LC agrees with you, but then I did not disagree, I just wanted clarity. What I now understand that those with DDNOS-1 have Ego states that ACT like alters. This makes sense, but the way many talk that have DDNOS-1 - it sounds like they have alters, but perhaps its because they have DID - I don't know. I always did totally understand that the dissociative disorders including ASD to DID are on a continuum. My problem was wanting a black and white answer as to what it is that those with DDNOS-1 do have - and I think many have this same question. I wrote a quick summary, but it took my LC at least 3 hours of our 7 hours together yesterday (and we weren't done, but a snow storm was underway so I had to go) to get me to accept something this idea. I hate to ever say exactly what he says, because I leave out so much, but do grasp the general idea and of course try and get the bottom line even though its' not black and white. There are hours of stats, philosophy and anthropology lectures that go with it and I like to summaries it into one sentence.

Also - the following is not meant to go toward anyone in this group. It's just observation I have had in my last year from many places including the internet.

The other point I want to make - Structural Dissociation (ANP - EP), DSM categories, testing and many sessions of watching how a person talks, moves, reacts to things along with so many other things that I can't think of right now, all come together to help a clinician diagnosis a patient. [b]No one - not even The Haunted Self authors, Van Der Hart, Nijenhuis, Steele use JUST structural dissociation, the DSM or a test to diagnosis a patient.

Psychologists have had years of training under supervision until they were considered proficient to go out on their own and diagnose. We may feel like we know something, but it's very likely we have gone in the wrong direction.

Even those with years of training under supervision are not experts. They are not what I consider to be experts anyway. That said, they are far better qualified to diagnosis someone than we are ourselves for so many reasons. Those psychologists that have not read and understand all the information out there - such as structural dissociation are at a huge disadvantage. One should use all the skills available to perform their job. However, one psychologist may say you have one thing and another say you have something else. Here lies the problem and so we tend to take it into our own hands due to lack of skill out there. Those of us that study and read up on something, without such supervision can get way off track.

To me an expert is someone of the caliber of Kathy Steele, Elizabeth Howell, van Der Hart, etc... - not those that write about DID or in no way the average clinician, researcher or psychologist. What I call an expert truly is one. If anyone disagrees with this, they should sit down with one of this people and try and debate their cause. I think they will come to the same conclusion if they have any sense of rational thinking at all.


I hope this clears up many things.

Tylas, I'm responding to this only because I can see how much all of this really means to you and it is obviously consuming a lot of your time. I'm just going to say, that I have read all of the people you've mentioned and much more. I have attended seminars and spoken directly to several of these people on numerous occasions. And, yet, I stick with what I've already said- these words and labels you keep talking about are concepts that are not agreed upon by everybody. They are abstract attempts to describe a phenomenon that is not black and white. You are taking some very complex readings way too literally and simplistically. You are doing what many people (professionals included) mistakenly try to do and that is put boxes around something that cannot be put into a box. That is the problem behind these diagnoses and terms. The only definitive difference between DID and DDNOS is level of dissociative severity. Period. There is not some "thing" that exists in one and not the other. Stop trying so hard to make everything fit in a way that makes sense to you and instead try to open your mind to allowing a bit of abstract uncertainty into it.

I have to wonder why you are so obsessed over this? Trigger warning for you:
It seems like you might be focusing on all of this stuff, including the intricate specifics of your own system, in order to avoid all of the yucky emotional stuff that is really at the root of all these disorders. When it comes down to it, all of this stuff is just traumatic responses, avoidance, denial, and deep utter pain that we all have and need to deal with. That's what really matters. And it's there that true healing exists.

boopsy26 wrote:I have to wonder why you are so obsessed over this?

I have to ask the same questions. Why have you read so much and attended those lectures? You want to know and understand. So do I! In my case it has nothing to do with my job, but that is how I do everything. I dig into it so that I can understand it. I fall a lot on the way, but I want to know. And yes, I do have to have my categories. I am working on that though! Boy did I get a long lecture on that one yesterday!

Maybe you missed the most important part of what I wrote. That a clinician looks at all sorts of things - not just one. You don't have to agree with them, but if anyone is relying on just one thing to make a DX is that not wrong? In that case everyone could just use the DSM and DX themselves by marking yes or no to those 4 questions its lists.

Without a doubt parts of me want to avoid the emotional stuff, but so far I have not backed down from anything, but it might still be the case. I don't know.

I like your input! You make me think and look at things differently! This is why I come here. This is the one group where we are actually allowed to discuss things and try and figure them out. There are support groups, but here we can have threads about both and I really do like that! There are many here that I value their input and of course you are near the top of that list.

You said you do not agree with all of "them." Does this mean the authors of the Haunted Self? I did not list many.

What about E. Howell? Do you consider her to be an "expert?" E. Howell just happens to be closest I have ever come to having a idol. She seems to get DID. Do you disagree?

Do you consider yourself to be an "expert?" Even if not, I would love to read about what you agree with and disagree with that these people I consider to be experts have wrote. It would be fascinating and a wonderful discussion!

PS... you don't have to put trigger warnings for me. I am so triggered by every day words and things. I find it helpful to get use to them, not ignore them. I try and remember to put the trigger thing up but I just don't get it.

Thanks Tylas.
Yes, I too want to understand. I guess I am able to be ok with the uncertainty and ambiguity though. In part it's my job, but in part it's because I want to know how best to get better. I don't care about trying to label everything- that's not going to make it go away. And, certainly, everything about this disorder is avoiding emotions, I'm no different. But, I'm also trying my best to work through that. Labels and words are not going to get me there. It's just noise that gets in the way of what's important.

As far as diagnosing goes, yeah, any clinician worth his salt is going to use many different methods to diagnose somebody (of course that doesn't happen 99.9% of the time unless you're in a research study). But, when it comes down to it all diagnoses are still based upon those criteria in the DSM. And the DSM is crap. It is based on the expert opinions of a board of psychiatrists who are funded by the pharmaceutical companies and refuse to even consider much of what the real experts have to offer. It's politics at its best.

-- Sun Mar 18, 2012 10:05 pm --

I just saw the last part of what you wrote.
Do I agree with Howell, Kluft, van Der Hart, Ross, and others? Most definitely! But, if you read enough of their works you will find that they are saying the same thing as me, just in a very technical and complicated way. In fact, Howell goes to great lengths to use multiple terms for the same idea because she specifically states how much she hates labels. She has said that none of these words truly capture what is really being experienced, but there is no better way to try to communicate what "they" are talking about and referring to. Much of the language in this field is designed for the same thing- to try and communicate to others a description of what they are referring to. A huge problem develops when people start using those words as some literal, tangible thing. Whether it be DID or another disorder, it's the same problem. Disorders themselves are just descriptive categories that should not be taken as literal things. But that is a problem that's gotten way out of hand.

boopsy26 wrote: I guess I am able to be ok with the uncertainty and ambiguity though. In part it's my job, but in part it's because I want to know how best to get better. I don't care about trying to label everything- that's not going to make it go away.

Yep, got that lecture yesterday too along with the long detailed reasons why. I am still a stubborn sole! I must know!

boopsy26 wrote:And, certainly, everything about this disorder is avoiding emotions, I'm no different. But, I'm also trying my best to work through that. Labels and words are not going to get me there. It's just noise that gets in the way of what's important.

Perhaps when I finally get to process trauma memory, my obsession over figuring out what is what will end. I went to my LC yesterday insisting I did not have DID. Thus one of my great needs for clarification. I want to know who I am for the first time in my life. I ignored it for 50 years!

boopsy26 wrote:As far as diagnosing goes, yeah, any clinician worth his salt is going to use many different methods to diagnose somebody (of course that doesn't happen 99.9% of the time unless you're in a research study). But, when it comes down to it all diagnoses are still based upon those criteria in the DSM. And the DSM is crap. It is based on the expert opinions of a board of psychiatrists who are funded by the pharmaceutical companies and refuse to even consider much of what the real experts have to offer. It's politics at its best.

Yes, I agree about the DSM to a point, but I cannot remember the whole history and I did hear it yesterday and that was not the first time. It takes a lot of skill to figure out what is wrong with someone.


For instance - my 16 year old has been sick for so long. She had/has a milk intolerance she thought she outgrew because she avoids it and is still sick. She has reflux so bad she had surgery - Nissan wrap. Poor thing was prom chairperson and was so sick from the stress of doing all that work she barely made it home and left early. She cried for hours she was in so much pain, but this time it was backpain. She missed her after prom party, but her bf stayed by her side all night. She is tiny and thin, but has hemorrhoids or something similar as she describes them - she never let anyone look and did not get them until after the surgery. When she was younger she kept complaining of problems and doctors treated her for worms even though the meds never stopped the problem. She had all kinds of tests before the surgery - celiac, ulcer, etc.... You would think they could figure out what is wrong with her.

But as my LC says, a DX also involves elimination.

Now I get on the internet and I come up with Crohn's disease. Would I be so foolish as to go to the Doctor tomorrow and tell him what I think it is? Sure, even after saying all that against self diagnosing. I think this is part of the elimination process and we must say what we are thinking at least - but then let it be in the professionals hands - but of course go to one that you do trust.

My point is that medicine and psychology are not black and white, but there are still categories and labels and those things put many of us at ease because we can use that label to find more information on what we have.

When I first got the DX of DDNOS-1, it drove me nuts! I still did not know what I had. I could not find hardly anything on it. Although I would be happier with DDNOS-1 than DID, in many ways I am happier to have a solid label so I KNOW. Knowing is important to many of us.

All that said - JV the therapist I use to go to hated labels and did not want to DX me, but she still did. My LC feels the same way and neither give labels unless someone insists. Obviously I insist.

So - Here to accepting both ways of thinking and the freedom to either just do therapy knowing it's going to be the same for DID or DDNOS-1 or to wanting to know why they differ. My interest will change once I "get it". It always does and I go on to another thing I MUST know.

Sorry about your kid- I hope you start to get some answers on that one!

tylas wrote:My point is that medicine and psychology are not black and white, but there are still categories and labels and those things put many of us at ease because we can use that label to find more information on what we have.

When I first got the DX of DDNOS-1, it drove me nuts! I still did not know what I had. I could not find hardly anything on it. Although I would be happier with DDNOS-1 than DID, in many ways I am happier to have a solid label so I KNOW. Knowing is important to many of us.

I get this. Just keep in mind that psychological disorders are not like medical disorders, no matter how much they pretend to be. It can lead you to information, ideas for treatment, and some idea of etiology (on rare occasions), but it's still a general description. If you go to a doctor with a fever and throwing up, he doesn't diagnose you with fever-throwing up disease. Nor does he say it's the flu. There will be tests and background and then elimination through a throng of different diagnoses that have the same symptoms but completely different causes, treatments, and outcomes. If you go to a psychiatrist, he will diagnose you with fever-throwing up disease, say the etiology doesn't matter (or it's "biological"), and send you on your way with some trial and error medication that may or may not work. This is only a slight exaggeration

Anyways, knowing something is important. We are all on this site because we want to try and find others who understand us in ways that doctors don't. We are all on here trying to discover for ourselves who we are and how to find new ways of coping and dealing with this. I like that you're so keen on things and wanting to be technical... but at a point it just becomes sabotaging and starts to get in the way. That's all I'm trying to say. Maybe just relax a little and try to KNOW how to cure world hunger- that should keep you fully occupied for life

I have that in the plans!

2 daughters are going to Africa for a couple of years to work on that sort of thing.

Keep in mind that I ignored all things in my head and family for 50 years, so I am doing a crash course, which is my usual way. I am not obsessed at all - well, I am but that is how I do things. I have far too much to do. I write books (not on DID!), run a business, hike, dance and have 5 kids, 4 at home and 4 grandkids next door and all of them are involved in a multitude of sports and I go to all that.

But - I am impatient and dive into things until I get them fixed. My DID is nothing different. My poor LC has to hold the reins. I want everything now and he keeps throwing ice on me! I think his FT job is just trying to slow me down!

-- Sun Mar 18, 2012 3:51 pm --

boopsy26 wrote:I just saw the last part of what you wrote.
Do I agree with Howell, Kluft, van Der Hart, Ross, and others? Most definitely! But, if you read enough of their works you will find that they are saying the same thing as me, just in a very technical and complicated way. In fact, Howell goes to great lengths to use multiple terms for the same idea because she specifically states how much she hates labels. She has said that none of these words truly capture what is really being experienced, but there is no better way to try to communicate what "they" are talking about and referring to. Much of the language in this field is designed for the same thing- to try and communicate to others a description of what they are referring to. A huge problem develops when people start using those words as some literal, tangible thing. Whether it be DID or another disorder, it's the same problem. Disorders themselves are just descriptive categories that should not be taken as literal things. But that is a problem that's gotten way out of hand.

Yeah, have to watch for my edits. I try not to do them after a reply but sometimes they are close! Yes, she does. She hates the word host and explains why and explains why she will still use it at times. I agree with what you wrote, but at the same time I think it's important to get everyone on the same page as to terms and labels written. Take the word dissociation for instance. The book haunted self really goes into this. I have been trying to sort that one out too, but then there is my need for a label that works even though I do agree with what you wrote above.

You are going to think I am nuts but here is what I have on trying to figure out what dissociation is. Again my LC and I are at odds on much of this but only so much sinks into my thick skull at a time.

http://dx-dissociative-identity-disorde ... ation.html

Speaking of all that.....

This is another thing that's eating at me.... Again, tapping into the knowledge and experience of the board members here:

I feel like my Alters all have ego states!

I just got an odd look from my LC. I don't think he knew what to say to this and that's odd.


Anyone else feel like this?

We were talking about normal ego states and well - --- the stuff on this thread and some of my Alters demanded they have normal ego states.

Thoughts?

tylas wrote:I feel like my Alters all have ego states!
...
Anyone else feel like this?

I wouldn't be surprised if they do. If you acknowledge that some of them are developed almost to the point of people, then you should acknowledge that, like people, they have their own ego states.

F*ck, I know we do. I act differently around one of our online friends than I do when I get pulled to front to play clarinet. And I act different still around one of our real life friends. And Rage... God, the kid's a headcase. She's an alter. A host alter, sure, but an alter. And she's probably got her own ego state problems even without our help. And Kayden. When Kayden fronts, it's too protect, and she's a sullen, bitter, angry b*tch. But she's fine with occasionally joking with our friends online. She's more over protective to Rage and Katherine. And she's Helena's d*mn b*tch. Yet it's all Kayden, no new alters.
~Mad Hatter

I believe we have to continue using these terms, these two categories or their synonyms for now in order to help newcomers understand what's going on with them.

The issue I see happening again and again among newcomers to this board is confusion about not having differently named parts who have unique identities, who they can lose or have lost time to, etc. For them I think the distinction between alters (or whatever you want to call them) and ego states (or whatever you want to call them) is helpful. What they know about alters only makes them confused and feel they must be making it all up because they're co-conscious when these different moods or states overtake them and they still feel like themselves to some extent.

So regardless of what theory or the DSMs state, I think it's important for newcomers to have their experiences heard and validated. Terminology can help validate someone's experience because terminology helps you communicate concepts, vague ones but still with enough shape that communication occurs.

In my system we still experience ourselves as different people most of the time. At the same time, we know we're part of the same body and person. So what validates our experience is calling us alters. Calling the qualia* of our experience ego states or dissociated moods or dissociative states might be more palatable now than it was a year ago but it's still like somebody's theory laid down on top of us.

Let's admit that another confusion about this board is that this forum is named for DID. Everyone is welcome here since there's so much overlap in experience between having alters and ego states plus the other forums just aren't as active. The bare majority here do seem to have DID or are the SO of someone who has DID but there are always several times as many lurkers as posters. Maybe it should be called something like "disorders involving dissociated identities or ego states." I am NOT proposing that, but you see what I'm saying.

Now that I've set up the dichotomy between alters and ego states, I'll say I'm well aware from reading about people's subjective experience here online and in books, articles that neither definition begins to express all the subtleties of any one person's system nor do they cover the range of cases that fall somewhere between.

*qualia: the experiential or "what it's like" character of a mental state