A Collection of Curious Things

"A mental disorder is a syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or development processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g. political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above."

“The DSM-5 wording indicates that mental disorders are usually associated with significant distress or impairment. The word ‘usually’ may be technically accurate, in that on rare occasions, a mental disorder is listed in DSM-5, and there is no ‘clinical criterion’. However, given that psychiatric symptoms are often on a continuum with normality, the clinical criterion is one key way of providing a relatively valid and reliable marker of underlying dysfunction, so lessening the risk of false positives and over-medicalization.”

“The insistence of staying Plural even as at the end of therapy is something I've encountered throughout my career. More conservative leaders in my field insist that there's only one cure to DID and that's complete fusion and integration. The fact of the matter is that it's up to the client to decide how they want to be and how they define themselves. From my perspective, and that is in line with the DSM principles, one can have all the phenomenological manifestations of the DID, but if there’s a sense of well-being, internal communication, cooperation, awareness, exchange of information, and external functioning is intact, then it's just a different way of being. It's not a disorder.”

“It's when they are unable to meet their obligations in real life and are unable to advance their goals in life, when they are experiencing internal strife and conflict and are paralyzed and unable to conduct their lives effectively [that it’s a disorder]. That's in the functioning domain. That's one criteria, a very important criteria. Scholastic, academic, work, family relations, functioning and all that, if it's not impaired, then there's no problem. That's the objective criteria. And then the subjective criteria is distress. So if you're not bothered by multiplicity in the sense that you don't feel that you're being taken over against your will, if you're not losing time, if there's no depression and anxiety associated with this disorder, if some parts are sort of leaking distress to other parts. That subjective criteria is another important indication that one needs help. But in other situations where these two criteria are not met, a person can be completely dissociative in the sense that they are functioning as a system and still not meet even the DSM criteria. Because in the DSM, for almost each and every diagnostic entity there is a condition that it must impair functioning or create distress. And unless this condition is met, then there is no diagnosis.”

“There's a great need out there to identify those who have multiple worlds and identities to identify the other forms of multiplicity and dissociation out there, and to label and understand better the variance ranging from normal and adaptive to excessive and abnormal and distress producing, and develop ways to help those who need help and want help. That's where we're at now.”

"It was apparent from visual inspection of the data that most of the MPD cases in the general population were radically different from clinical MPD patients. These people often did not report abuse histories and often reported experiencing little psychopathology. They had low DES scores (only one scored above 20). By reviewing the DDIS profile of each person positive for MPD I identified six individuals who appeared to have pathologic posttraumatic MPD, which was 1.3% of the entire sample."

"These six individuals had abuse histories and substantial amounts of symptomatology. For instance, two met criteria for BPD and four had had a major depressive episode. Although they were clearly more symptomatic than the eight individuals positive for MPD who did not report childhood abuse, they were not as disturbed as clinically diagnosed MPD patients. Eight cases (1.8% of the entire sample) were possible false-positive diagnoses of MPD in individuals who did not report childhood trauma or extensive symptomatology."

"Although the study yielded only a small sample of 14 individuals positive for MPD, the findings raise a number of issues. How should we think about the eight individuals who felt they had distinct personality states, but who did not appear to have clinical MPD? The first possibility is that the DDIS is not valid in nonclinical populations: These eight individuals may have DDNOS or no DD. In the absence of blind validation studies, all conclusions must be tentative."

"The second possibility is that there is no problem with the DDIS, but instead with the DSM-III-R criteria: Perhaps the DDIS reflects the true prevalence of DSM-III-R MPD in the general population, but the DSM-III-R criteria yield false positives. Third, several of the eight apparently atraumatic individuals may be amnesic for abuse they experienced and unaware of their amnesia. Some of these individuals may be in a period of quiescence or remission, may have had more florid MPD in the past, or may develop overt MPD in the future if subjected to enough stress."

"Another possibility is that multiplicity exists in a nonpathologic endogenous form in the general population. About 2% of people may be natural multiples who do not have dysfunctional posttraumatic MPD, They may simply have a highly dissociative psychic organization. If subjected to child abuse, these individuals would have developed clinical MPD with all its symptoms, self-destructiveness, and dysfunctional amnesia. The threshold for development of pathologic MPD in response to trauma is presumably low in such individuals, if they exist."

"DSM-III-R criteria function well in clinical populations to differentiate MPD from other diagnostic groups, however it appears that more complex criteria are required to differentiate pathologic MPD with numerous personality states, complicated amnesia barriers, and severe trauma histories from individuals with nonpathologic atraumatic multiplicity."

"The existence of mild, nonpathologic variants of MPD in the general population is consistent with the findings for all other forms of mental disorder. Simply having distinct personality states that feel subjectively like separate people may not in itself be a mental illness. This may be true even if the personality states have separate names and converse out loud with each other inside the person’s head. The DSM-II-R criteria for MPD do not make this distinction between psychiatric disorder and normal psychic organization. It is likely that the 14 individuals positive for MPD in the study have provided preliminary information about a heterogeneous group of people, some with disorders of varying etiology, and some with no psychiatric disorder."

“There is no reason why this should not apply to the dissociative spectrum - some people will not develop DID no matter how much trauma they experience - while others will do so with less trauma. It is logical that here are some people who are more organized in terms of separate parts as part of their endowment - in the absence of severe trauma they may have a few parts but no severe internal conflict or amnesia. I don't think it's productive to debate whether the parts in non-traumagenic multiples should be called parts, alters, or something else.”

“It can be boiled down to several categories. 1. DID and OSDD as defined by DSM-5 - which require distress and dysfunction. Neither of these require trauma by DSM-5 rules but there virtually always is trauma. 2. Other DSM-5 dissociative disorders. 3. People with parts and trauma but no distress or dysfunction. 4. People with parts but no trauma, and no distress or dysfunction. - Like everything in DSM-5 there are mild versions that don't meet full criteria and don't have distress or dysfunction. One of the problems in the discussion is that people often have fixed ideas and rules about 'how it has to be' - unfortunately for them, the real world doesn't always follow those rules.”

And it's certainly not "I love getting worse" when medical literature acknowledges it as a positive and non-distressing experience, as you can see in the below references.

You seem to be unaware of both what plurality even is, and what 'system' means - we recommend you don't go around calling people confused and uneducated.

For 'system', we suggest this pre-written list of references, since we don't want to copy/paste them all.

For 'plural': (you can find additional references on this list here using 'multiplicity' instead of 'plurality')

- "The third group that may be less familiar to clinicians, includes those identifying as Plural, but not considering themselves “disordered”. This group may include those with philosophical or spiritual practices that lend to an experience of multiplicity but do not consider themselves traumatized by this, as well as those who have chosen functional multiplicity as a goal for treatment rather than integration – and who do not consider themselves “disordered” because they are functioning and not distressed by symptoms.”

- "As for those who may identify as Plural but report no trauma history, there is valid concern on several counts. One, is that reports of Plurality without traumagenic origin could undermine the most recent research that defends DID as a trauma-based disorder against those who have dismissed it for far too long, despite so much research and evidence already. However, even within the Plural community, Plurality is a broader concept than DID, and that is understood by Plurals who claim no trauma history. Furthermore, the research confirming DID as a trauma-based disorder is doing just that: confirming traumagenic DID, the disorder, not Plurality, the identity.”

- “Many multiples with DID therefore are not plurals. Conversely, there are plurals who do not have DID. Of those plurals who don’t have DID, many once met diagnostic criteria but no longer do, while remaining multiple. They may cease to meet criteria because they no longer meet the distress/impairment criterion; on clinicians’ parts, the judgment as to whether or not a multiple merits the diagnosis of DID will probably especially often concern whether the client’s multiplicity per se is impairing them. But plurals may also not meet diagnostic criteria because they no longer meet the amnesia criterion as the latter is framed, since multiple headmates may share their knowledge and experiences with each other. Some plurals identify with the diagnosis to the extent that they believe that their system was produced by trauma—a major factor in the etiology of DID—but claim that they never strictly met diagnostic criteria.”

- “Then there are “natural” or “endogenic” systems. Some claim that they were just always multiple people, without ever having experienced childhood trauma of the sort that is generally believed to be the precipitating factor for DID and without having intentionally and effortfully created headmates in the way that tulpamancers do; other natural systems say that while they have experienced such trauma—just as have many singlets—they were already multiple by that time. Natural systems’ causal origins could perhaps just be some kind of neurobiological difference (or abnormality); alternatively, several systems I spoke to expressed the belief that authors may sometimes inadvertently create headmates in the process of vividly imagining fictional characters. Note that this could be viewed either as inadvertent tulpamancy or—from the standpoint of a narrative account of the self—as just the same sort of process by which a singlet brain “creates” one person.”

- “Plurality and dissociative identity disorder are not exactly the same. Being plural, or having two or more people existing in one body or space, is just one part of the diagnosis of dissociative identity disorder. Many people who are plural do not experience distress from the existence of others within themselves although dissociative identity disorder and plurality are frequently associated with trauma, there are those who are plural and report no history of trauma. The case presentation in this chapter describes someone with severe trauma, but this is not a definitive or universal reason for the existence of plurality.”

- "In psychology, plurality is when multiple personas characterized by completely distinct thoughts, emotions, and preferences are manifest in one person. The condition, which is also known as multiplicity, is usually considered part of a dissociative identity disorder (DID). This means a person is out of touch with reality (dissociative) in understanding who they are (identity) to the point of experiencing adverse effects in their daily life (disorder). However, a person may resonate with having a plural identity without it being diagnosed as part of a disorder; they might not find their plurality to be distressing. Plurality is considered a disorder when a person exhibits depression, delusions, anxiety, substance abuse, loss of memory, suicidal tendencies, confusion, or a combination of these symptoms.”

- "Though the causes of some plural systems are unknown, psychologists and other mental health practitioners have reported some reasons common to many cases. Plurality may be deemed a traumagenic system, a spiritual system, or tulpamancy. Plurality means that one person manifests or exhibits two or more distinct personalities. When the plurality is deemed a mental health concern, the person might be diagnosed with dissociative identity disorder (DID). Other forms of plurality may not be distressing to the individual; perhaps they are even sought out. Statistics show that about 1.5 percent of the global population is diagnosed with DID, a mental health disorder characterized by plurality. However, since plurality takes many forms, including spiritual systems and tulpamancy, it is difficult to ascertain just how common plural systems in general are.”

- “Plurality is a newer, more inclusive term that our study uses to describe the broad range of experiences of having more than one person or entity sharing one body. It has been used in the scientific literature as well as the self-advocacy community, and is an addition to the related terminology of dissociation and multiplicity. The term system is often used to describe a collection of these entities sharing the body."

- "Plural identity is a self-reported identity, not a specific clinical diagnosis. Some, but not all, plural people dissociate, or have a psychiatric diagnosis of dissociation such as dissociative identity disorder (DID), or other specified dissociative disorder (OSDD). There is a diversity of experiences within plurals/systems, such that members of a system may have different gender identities and salience of gender; ages/experience of age; perceived internal appearances; varied beliefs, memories, feelings, and thoughts; and complex interrelationships with other system members."

- "A subset of scientific literature recognizes that experiences of multiplicity manifest in non-pathological presentations, and has found value in a holistic or non-pathological approach to dissociation. A recent literature review by Eve, Heyes, & Parry conceptualized a continuum of multiplicity experiences ranging from nonpathological multiplicity to clinical DID. They noted that professional ignorance of nonpathological or subclinical multiplicity resulted in the over-medicalization of participants’ experiences.”

- "The present study uses the term ‘plurality,’ which emerged from the advocacy community of multiples, and recently has been incorporated into the scientific literature. This newer, more inclusive term describes a broad range of pathological and non-pathological multiplicity, denoting those who have more than one person or entity sharing one body as a ‘plural system.’. While the term ‘plural’ includes those in clinical distress and diagnosed with a dissociative disorder (DID or OSDD), authors have noted that many identifying with plurality found ways to live well with dissociation or did not experience distress from plural experiences.”

- "The term ‘plural’ includes those fitting the diagnosis DID or OSDD, which is caused by early childhood trauma, but also includes other forms of plural identity. The majority of plurals do not strive to become one personality, a singlet or singleton, but aim for a state of ‘functional’ multiplicity."

- "We shall define multiplicity as the phenomenon of multiple persons, personae, or selves manifesting or being perceived to exist within a single embodiment. This definition follows existing use of the term, excepting that it inclusively recognizes the autonomy and personhood of these ‘selves’ in their own right, rather than treating them as mere manifestations, perceptions, or ‘states’ of a singular person. This preference reflects the prevailing (though not exclusive) understanding of selfhood by those who experience plurality, as well as the constraints imposed by a sympathetic understanding of other forms of multiplicity, some of which will be discussed forthwith. Multiplicity exists on a continuum, and it may not be possible—let alone desirable—to differentiate, categorize, and label every possible experience thereof. As such, the survey that follows is not intended to be exhaustive, but rather to illustrate the historical, social, and clinical background that informs contemporary understandings of the phenomenon. Three prominent explanations for or forms of multiplicity will be treated: spirit possession, dissociation (especially as realized in the form of dissociative identity disorder), and finally plurality, which will serve as our focus for the remainder of the article.”

- "The connection between plurality and pathological dissociation, however, remains a point of significant contention. Communities which would eventually coalesce under the banner of plurality began to emerge in the aftermath of the DSM-III’s diagnostic formalization of ‘multiple personality,’ which notably lacked the requirement of distress or impairment present in more recent revisions of the DSM. This subsequent narrowing of diagnostic scope has resulted in many experiences that may previously have been considered pathological no longer meeting the criteria necessary for clinical diagnosis. Although this in turn precipitated a shift toward non-pathological understandings of plurality among those who experience the phenomenon, some in the plural community remain committed to the basic clinical framework as articulated by the DSM, and—echoing etiological debates regarding dissociative identity disorder—express skepticism toward non-traumagenic experiences of plurality. This commitment can result in frustration for patients unable to find validation of their experiences through clinical diagnosis, as well as for clinicians who must contend with what they perceive as factitious diagnosis-seeking.”

- "Countering the clinical view, others have decried what they allege are attempts at the medicalization of plurality. This position is well represented within the plural community, where many ‘endogenic’ systems refute clinical expectations of underlying trauma. Further, even among trauma-based systems, many experience no distress or impairment on account of their plurality, and thus neither consider themselves to be disordered, nor see integration as a therapeutic goal. While such understandings undoubtedly originate within the plural community itself, they can also increasingly be found in academic literature; recent treatments of plurality have viewed it as non-pathological and phenomenologically-distinct from dissociative identity disorder. Despite this, existing research on multiplicity-spectrum experiences is often undermined by imprecise definitions and mistaken understandings that conflate non-pathological manifestations of plurality with those properly described by dissociative disorders, obscuring the scope and applicability of such research, and of its findings. In consideration whereof, further reference to ‘plurality’ in this article shall consider only holistic, non-pathological manifestations of the phenomenon.”

- "Because non-traumagenic plural experiences rarely affect functioning, they have fallen very much under the radar of researchers, academics, and mental health professionals. The existing body of research on non-DID plurality is limited to online surveys and theory, and this must change. The lack of social, scientific, and medical awareness and understanding of plurality causes stigmatization, misdiagnoses, and mistreatment. Further research is a necessity to counter this."

- "Plural experiences are not limited to tulpas and dissociative disorders. In fact, when the diversity of plural experience is considered, multiplicity may seem to be less of an extraordinary achievement and more of a fundamentally human experience. Many fiction writers, for example, report that the characters of their design seem to come to life in their heads, behaving autonomously and being perceived as full-fledged consciousnesses. Religious individuals of faiths where the God, Gods, or spirits they believe in can interact with them to a degree report similar phenomena, regardless of their specific religion or culture. There are also online communities tangential to tulpas where members report being plural as long as they can remember, but do not experience uncontrolled dissociation. And, of course, there is also tulpamancy. Tulpamancy is one way to willfully create new identities. It is a means to become plural."

- "While plurality is widely accepted within the Tulpamancy culture, it could be argued that the mental presence of a non-physical entity may be indicative of disorders such as Dissociative Identity Disorder, Schizophrenia, or Schizotypal Personality Disorder. While the experience of tulpamancers could fit diagnostic criteria such as the presence of multiple personalities, delusions, or auditory hallucinations, there are reported advantageous qualities of Tulpamancy which lead to questions as to whether their experience results in significant distress or impairment."