How does DID Develop? *Category Triggers

My thanks also of this thread and links to those articles (though some of them I've read)!

Especially thanks, Tylas, of the comments of your LC! They are very interesting!

yakusoku wrote:Thanks to both of you for the articles posted. I have read those, though a while back, so perhaps they could use a reread. The dependency one was useful, but not the one I was thinking in terms of disorganized attachment and DID. I still can't find it, but here a couple other articles that relate which I have read, though I think the one I first posted probably included these in some of its references, or at the very least references the authors' work.

http://www.peterbarach.com/MPD%20as%20a ... sorder.htm

http://www.empty-memories.nl/science/Li ... chment.pdf


Tylas - Thanks for sharing your LC's input again. I hope he has time later to give it a more thorough read. One of the points that caught his attention was something that drew mine as well. I almost started excerpting quotes and commenting on here, but I'm trying to be good at not checking out on the real life three-year-old and my H right now, so I have to be careful not to devote too much time to it. I can really get sucked in at times.

Yakusoku, thanks for these articles. Traumatic episodes aside these articles are helping me make sense of attachment issues of me (and my siblings tbh) and why my family is so dysfunctional. It was never clear to my why parts of me thought it would have been better if when my mom left she was just gone rather than having this contact in which she absolved all responsibility as a mother. And how as a young child we felt though she was present she was never there for us. In the past few years I blamed it on her NPD and thought at least we were fortunate enough she used us now and again for her narcissistic supply (at least we got some attention and affection) however I see this inconsistent parenting and affection to meet her needs contributed to the disorganized attachment.

Thanks for these articles
Sam

SamsLand wrote: I feel like references to the "parenting profile labeled hostile/self-referential had significantly higher rates of role confusion (self-referential behavior) and negative-intrusive behavior" etc is a description of both of my parents.

I can't deal with my Mother either! I will have to go back and read this with that in mind. I think it's good to admit you hate a parent that abused you! I bet they forbid us to ever express such a feeling!

-- Tue May 29, 2012 12:57 am --

quadretto wrote:My thanks also

You are welcome! He is awesome. He teaches me so much, but only what he thinks I can handle at the time - which is most things, but usually he waits for me to question stuff. He says I ask more questions than a human has a right to! Today was an eye opener session! Whoa!

He was approached to do a show like the Dr. Phil show. He is so dang verbal he would be great at it, but he turned it down. Even if he liked that sort of thing, at almost 70 years old - he wants to spend his time doing what he loves - writing.

I told him today he had a fan club. He got a kick out of that.

Tylas, if you happen to notice anything that elaborates on secondary structural dissociation, could you please pass the reference my way? I really would like to develop a better understanding of dissociation as it relates to C-PTSD and DDNOS.

Thanks!

Have you read the Haunted Self? Anything since about 2006 from the authors of this book talks about it!

DDNOS-1 fascinates me. I wish there was more information out there that does focus on it. It's sort of everything between PTSD and a system with more than one ANP - so it does cover a lot!

The way I think of it is that with DID - the ANP's buffer things. With PTSD and DDNOS-1 the person is getting blasted.


Do you have a specific question?

I do have this that I put together a while ago:

PTSD, C-PTSD, DDNOS, DID and how they differ
Disorders may be classified by etiology (cause or origination), symptoms or operational definitions such as in the DSM. The DSM defines something in terms of the specific process or set of validation tests used to determine its presence and quantity. I have also added structural dissociation as a method of classification which "provides a taxonomy of dissociative symptoms. It postulates a common psychobiological pathway for all trauma-related disorders." The terms ANP and EP refer to prototypical dissociative parts of the personality.

I. Post Traumatic Stress Disorder - PTSD

Etiology if separated from C-PTSD: Common in War or Rape Victims and usually from trauma experienced after childhood. It is adult onset rather than caused from childhood trauma.
Symptoms: flashbacks, hyper or hypo-arousal (numb, emotional detachment, drowsy), nightmares, panic attacks, etc.
Structural Dissociation: 1 predominant ANP, 1 EP lacking much autonomy

Complex-PTSD or DESNOS - (Disorder Extreme Stress)
Complex PTSD is a category used by many therapists which is not yet in the DSM and it does not look like it's going to be in the proposed DSM 5. It was proposed by Herman (1992) to expand the PTSD DX for those who have been continually traumatized over a period of months or years.

*Note - this is not DDNOS or DID which are Complex Dissociative Disorders rather that PTSD.

Symptoms: often include some of the same symptoms of PTSD, in addition there are problems regulating emotions and more severe dissociation than "simple PTSD". Some parts of the self feel shame and guilt, while others may feel good about themselves, trust issues, physical symptoms, some parts look at life as good, other parts see it as bad. These are not Alters, but the ego states are often confusing to the lay person who thinks they must have alters when indeed they do not.
Etiology: "DESNOS or C-PTSD develops when extreme trauma “compromises the fundamental sense of self and relational trust at critical developmental periods.” So unlike "Simple PTSD", C-PTSD is often childhood associated.
Structural Dissociation: Usually 1 predominant ANP, 2 or more EP which are usually more elaborate than EP in primary but less than in tertiary.

II. Complex Dissociative Disorders
Do not confuse Complex Dissociative Disorders with PTSD, but understand that those with Complex Dissociative Disorders can also have PTSD - or it might be better thought of as parts of them can have PTSD. Consciousness is altered in the dissociative patient in a way that experience of time, place or their sense of self is profoundly altered. I only discuss two types of dissociative disorders here, DID and DDNOS-1 which is in many ways similar to DID and just as many ways it is not. Keep in mind that symptoms may overlap all the way on a continuum from PTSD to DID. This is important to understanding. If you have DESNOS, DDNOS-1 or DID. Parts of you can and often do have symptoms of PTSD as well.

Dissociative Disorder-Not Otherwise Described Type 1 - DDNOS-1 - Soon to be DDNEC

Symptoms: Dissociated and compartmentalized parts, but the major hallmark symptoms of DID such as time loss are not present. The DDNOS-1 patient does not have more than one ANP.

Etiology: Similar to DID etiology - see below
Structural Dissociation: Usually 1 ANP and 2 or more EP

Partial Dissociation
E. Howell describes partial dissociation which is what DID has in common with DDNOS-1.
"When we speak of partial dissociation as an important aspect of DID, it is important to note that partial dissociation is not specific to DID or even to dissociative disorders. It also characterized PTSD."

Flashbacks are an example of partial dissociation. It's when we are influenced from within - taking partial control.

Structural Dissociation, DSM categories, testing and many sessions of watching how a person talks, moves, reacts will all come together to help a clinician diagnosis a patient. No one uses JUST structural dissociation, the DSM or any test to diagnosis a patient with DID or to figure out if they have DDNOS-1 or DID.

DID - Dissociative Identity Disorder
The person with Dissociative Identity Disorder, according to [Understanding and Treating Dissociative Identity Disorder E. Howell 2011] has at least two "active and subjectively autonomous strands of experience [ANP] that are rigidly and profoundly separated from each other in important ways."

Etiology: Overwhelming stress (typically extreme childhood mistreatment)
Insufficient nurturing and compassion in response to overwhelmingly hurtful experiences during childhood. Dissociative capacity (ability to uncouple one's memories, perceptions, or identity from conscious awareness)

Symptoms:
Significant Time Loss - An Alter will take over and there is a loss of time where you do not have any memory at all of what occurred during that time period.

Pseudoseizures and other conversion symptoms are relevant to the diagnosis of DID.
Structural Dissociation: At least Two ANP and Two or more EP.

tylas wrote:Have you read the Haunted Self? Anything since about 2006 from the authors of this book talks about it!

DDNOS-1 fascinates me. I wish there was more information out there that does focus on it. It's sort of everything between PTSD and a system with more than one ANP - so it does cover a lot!

The way I think of it is that with DID - the ANP's buffer things. With PTSD and DDNOS-1 the person is getting blasted.


Do you have a specific question?

No, I haven't read the Haunted Self. I want to see if my library can get it from another system before I buy it. I have read several articles by the authors. In fact, it was a huge relief to me to read about their theory of structural dissociation, because I felt that I was finally reading something that could apply to me. I found it fairly soon after I started to go spelunking for journal articles this time around. I hadn't read much in the literature since 2003, because of a lengthy hiatus from doing any trauma work, and things have certainly changed in the last 9 years!

I should go back and re-read some of the articles- unfortunately, having all of these child parts so active these days has really interfered with my reading comprehension and retention of information.

Basically, I am just trying to better understand what is going on with me. The last 6 months have been pretty wild, because I went from "Well, yes, I used to have child states, but I don't anymore" to "Oh, I guess that I'm not as integrated as I had thought" to "I don't remember there being so many kid parts or them being so strong" (although I did see from my journal writings that things were similar to when I was dealing with them many years ago, I just didn't remember it) to "Wow, this is so much more complex than I ever understood, so much more communication is possible than I ever imagined, and I am able to work with them in ways that I never dreamed of before."

In regards to your comment about always getting blasted without having multiple ANPs to help manage things, yeah, it can be tiring and very, very painful. But it also makes me very motivated to learn skills that will allow me to manage the more difficult symptoms. And, well, I don't know any different. That is just the way that it is- I'm the one who has to deal with the outside world and all of the current stresses and take care of a bunch of internal kids who are very traumatized and who I am finally able to really engage and help. I see comments about how people with DID can get some of their parts to help take care of the young kids and I sometimes wish that was an option for me.

Sorry, it is late and I am tired, and I am just blathering now!

*Trigger - Structural Dissociation

I picked up The Haunted Self that last few days and have been reading. For those of you with DDNOS and Complex PTSD it brings to light fascinating ideas.

Here is a quick summary of how the structural dissociation goes:
For DID the age is an absolute criterion because the trauma MUST occur and inhibit the normal integration process of the mind that happens between birth and 5 years old - 8 at the latest.

A look at Structural Dissociation might help some.

Primary Structural Dissociation
(not an elaborate EP at all)
ASD - 1 ANP and 1 EP
PTSD - 1 ANP and 1 EP
Simple types of DSM IV Dissociative Disorders - 1 ANP and 1 EP (not an elaborate EP at all)


Complex Dissociative Disorders
Secondary Structural Dissociation
(EP more elaborate than primary, but less than tertiary)
Complex PTSD - 1 ANP and 2 or more EP
DDNOS-1
DESNOS
Trauma Related BPD

Tertiary Structural Dissociation
(usually several ANP's and elaborate and autonomous EP - often with named parts)
DID - 2 or more ANP and 2 or more EP

Not the topic, but would you say the haunted self is a good book for information on DID as well? I haven't read it but I know my T has.

lifelongthing wrote:Not the topic, but would you say the haunted self is a good book for information on DID as well? I haven't read it but I know my T has.

Then I would say your T is a keeper!


It's totally fascinating - a bible when it comes to Dissociative Disorders, but it is difficult reading. I keep plugging away at it. When I want deep details - this is where I do look. Kathy Steele (one of the authors) is a facebook friend. She is incredible. I have asked her about making recordings of her lectures and she is thinking about it.

The book I suggest anyone with DID read is Elizabeth Howells 2011 book. This book has it all, including the structural dissociation. The reading is not too hard to grasp either.
http://www.amazon.com/Understanding-Tre ... 0415994977

I have seen chapter 3 of this book on line in pdf form before. I don't know where, but it's out there.