dissociative disorder goes brrrr

one: the quotes i post are, to the best of my knowledge, accurate, and i state in the post where the quotes are from. however, i am not a professional myself, and it is possible that by taking these quotes out of context, their original meaning may be miscontrued. please use your own critical thinking skills when reading about any disorder!

two: the quotes i post largely revolve around trauma, and the majority specifically revolve around severe childhood abuse. particularly heavy or blunt quotes i will tag with trigger warnings so they may be blacklisted, but please keep in mind that this whole blog is about childhood trauma. if following this blog becomes unhealthy for you, by all means, feel free to unfollow.

The thing to remember is that in the middle of a meltdown and for a period after, the ability to verbalise and rationalise is not there. It has left the building. Another thing to remember with meltdowns is that there is no single cause and no ‘one size fits all’. Meltdowns can occur at different times and different frequencies. There may be a hormonal link just as there is with puberty, meaning that meltdowns can be more frequent during pregnancy.

I was on a quest for perfection and I had to be perfect. This is also a common feature in females on the autism spectrum. If you spend your life watching and copying, then the images that you see are usually the ones portrayed by the media as being perfect and good. It is therefore a natural progression to expect that your success and happiness in life depends on you being perfect.

I didn’t have an eating disorder but I had always been what my mother called a ‘picky eater’. My issues with food were nothing to do with being conscious about weight - in fact, I was desperate to pile on the pounds. My pickiness was more to do with sensory sensitivity to certain foods. I didn’t know it then but I have since discovered that I am hypersensitive to smell, taste and touch.

Many girls with autism are only discovered later in life, as I was, after going down the mental health route. Such issues can be anything from anxiety to eating disorders.

Throughout my career I have worked with many people who have met one person with autism so they think they know what autism is. They don’t. They only know how that one person’s autism affects them.

People with autism have difficulty understanding and predicting other people’s intentions. They struggle to imagine situations that are out of their own experience. This can result in high levels of anxiety and engaging in a narrow, repetitive range of activities that are familiar and therefore comforting to them. This is why people with autism love routine.

So why is it so important for us to be aware of the differences that females on the autism spectrum may experience? It’s important because society has an expectation that females are more sociable and more emotionally literate than males. If a female presents differently, she can be viewed as cold, aloof or just plain weird. This is society’s problem, though, not the problem of the person with autism. How can we change society? By raising awareness.

Experiential avoidance (Hayes et al., 2004) can be distinguished in synthesis, personification, and presentification. In avoidance of synthesis, survivors as ANP or EP avoid including particular perceptions. For example, dissociative parts may believe “I do not have breasts”; “That never happened”; “I do not feel anger.” When they avoid personification of what has been synthesized, they may say “These breasts exist, but they feel as though they are not mine”; “That happened, but not to me: It happened to someone else”; or “That anger exists, but belongs to that other part, not me.” Avoidance of presentification, which includes failures in synthesis and personification, might lead them to say “Since I do not have breasts, or they are not mine, I do not need to have mammograms”; “Whether I was abused or not, it has no impact on me in the present”; “I am not responsible for hitting someone because anger doesn’t belong to me.”

Survivors as ANP are often not able to fully be in the moment either, because they are avoiding internal and external reminders of trauma, again resulting in difficulties with synthesis. When intrusions of traumatic memories (and EPs) occur, their ability to be present becomes more limited. When survivors cannot tolerate certain stimuli, such as a feeling or memory, or the sight of someone who reminds them of their perpetrator, they will not be able to include these in their core and extended personification and presentification. Instead, these stimuli are avoided and survivors will engage in substitute actions to continue the avoidance: This is nonrealization.

It is also impossible to be present when survivors are fixated in the past. EPs often have such a severe lack of presentification that they are not even aware of the real present, much less able to act adaptively in response to it. They have their own, anachronistic sense of the present that involves too much of the past. Simultaneously, they also have a sense of self that excludes or only partially includes the sense of self experienced by other parts of the personality: A failure in personification. When survivors as EP reexperience a traumatic memory, they have a sense of personal existence across a limited stretch of time, fixated in the past that they perceive as the present. But neither that experience nor that sense of self is integrated with the present.

Core presentification takes a lot of mental energy and efficiency. It is not easy to pay attention to the stimuli and actions that really matter to us in the present moment without wandering off into the past or future, or losing an adaptive balance between conscious awareness of our internal and external world. And being fully present requires that we have a sufficient mental level to sustain our attention and to control serious maladaptive alterations in consciousness. It takes even more mental effort to concentrate reflectively on present action.

Core presentification is the action of being present in the moment. It includes making an account of our present action and experience (Janet, 1903, 1928a, 1935a) as being here and now, and as being real. Another component of core presentification involves adapting our immediate actions to this account. The account can be nonverbal, but putting it in words will give it a higher degree of reality. Our account of the present, a mental action in itself, is influenced by other mental and behavioral actions, and in turn, influences our behaviors in constant perception– motor action cycles. We do not then confuse the past with the present, or the internal with the external, but stay connected to the synthesis of our reality of the moment. It is often essential for patients to make conscious, verbal accounts of their core presentifications in therapy, because this helps solidify integration and thus stimulates higher level, more adaptive actions. For example, a patient might say, “I am sitting here on this blue couch in the therapy room and my therapist is sitting across from me, listening to what I’m saying. I am safe, and no one is going to hurt me.”

Survivors need much help in personifying their experiences, both in the moment and across time. This is a major component of realization that will be developed over time in therapy. All dissociative parts must be supported in raising their mental level to the degree that they can personify the experiences of other parts. Thus each part ultimately must be able to respond to the present moment and the history of the whole person and say, “This is my experience, my feeling, my body, my history.”

As essential as personification is, it can be carried too far when synthesis does not include adequate differentiation. For example, some survivors may come to believe that someone else’s experience is their own. One patient was confused about whether a memory involved him watching his father beat his brother, or whether he had an out of body experience in which he was watching himself being beaten. Another patient reported that she felt physical pain if she was near anyone in pain. A more common problem is that of becoming overwhelmed by someone else’s suffering as though it is our own: A difficulty perhaps not unfamiliar to many highly empathic therapists in response to their patients. In such cases we seem unable to “screen out” the experiences of other people and separate them from our own.

Each dissociative part has personified at least some degree of sense of self: “I feel; I think, I hurt; I know.” But personification may be extremely limited when a part has only realized a minimal amount of experience out of the individual’s entire history, such as a few fragmentary moments within an extended traumatic event. Some parts have engaged in little more than core personification involving the short moments of time in which they are fixated, hence lack extended personification. Such parts have a small basis of realization and, accordingly, a small range of action tendencies. For example, in simple PTSD, a single EP may encompass little more than one (core) personified traumatic experience and memory involving synthesis of pain sensations and fear. The more experience a survivor has personified within a dissociative part of the personality across time, the more elaborate this part’s autobiographical self will be and the more types of actions this part can engage in.

Survivors do not personify their actions in a given moment and across time under the umbrella of an integrated, unified personality. Their structural dissociation implies the existence of at least two “me’s.” In this organization, each dissociative part personifies some actions and experiences, but regards other actions and experiences as “not me” to some degree, including one or more other parts.