haze et al

The DSM-5-TR does not specify that they cannot occur together, just that the diagnostician must make sure that the schizoid symptoms are not caused by autism:

[Criterion B] Does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, another psychotic disorder, or autism spectrum disorder and is not attributable to the physiological effects of another medical condition. (emphasis mine)

And then in the differential diagnosis section:

There may be great difficulty differentiating individuals with schizoid personality disorder from individuals with autism spectrum disorder, particularly with milder forms of either disorder, as both include a seeming indifference to companionship with others. However, autism spectrum disorder may be differentiated by stereotyped behaviors and interests.

There is no mention of mutual exclusivity.

In fact, there has been research into the overlap between these disorders. One study found that autistic people tend to have more schizoid symptoms than non-autistics. Another study found that SZPD was the most common personality disorder in their autistic sample. There is also significant research in the overlap between autism and the schizophrenia spectrum in general; they are known to have a high degree of overlap.

"Rule out autism before diagnosing with schizoid PD" does not mean "no person could possibly ever have both". Please stop spreading misinformation in the comments.

Further reading:

Schizoid Personality Disorder vs Autism: Overlaps and Differences

Alters and the self-states that make up PTSD develop from the same process, just on different levels of complexity. If it were possible to split alters without trauma it would also have to be possible to develop PTSD without trauma, which it obviously isn't.

And importantly, splitting because of stress is not an exception to this.

The development of alters and PTSD is tied to a person's integrative capacity, which is made up of their mental energy and mental efficacy (ability to use that energy effectively).

When both of these are high, the person will easily be able to integrate their experiences even if those experiences are stressful or frightening. When both are low, the person will lose their ability to engage in more high level integrative actions, making them more vulnerable to structural dissociation until their integrative capacity recovers.

Chronic stress lowers a person's integrative capacity and prevents it from regenerating, and as a result people who have experienced complex trauma (which is required for the development of DID) tend to be stuck in a constant state of low mental energy and efficacy.

As such, if you have already been severely traumatized over and over, you are much more vulnerable to being traumatized again, even in response to things that a non-traumatized person would likely be able to cope with. This is what people commonly refer to as the "window of tolerance".

However, when that threshold is crossed, it is still a trauma response even if we wouldn't traditionally call the event that caused it "trauma". Neuropsychologically speaking, the exact same process of developing PTSD for the first time is happening when you split because of stress. Trauma is still trauma to your body and mind even if you're choosing not to label it that way.

I’m wondering if this means splitting a new identified alter or if this has anything to do with fragmentation of if it’s a different thing entirely

Because I don’t know, it was OEA so many we did split billions of times. Makes sense to me.

The majority of parts in people with high fragment counts are what's called parallel and sequential parts. These develop when a traumatic event is so distressing and overwhelming that a single EP cannot contain all aspects of the event, and so multiple form instead.

Parallel parts refer to multiple EPs that hold different "sides" of the same traumatic event. The most common form of this are observing and experiencing EPs, where one part remembers the visual and auditory components of the event but is severely emotional disconnected from it, and another part vividly remembers the physical sensations and emotions of the event but lacks logical understanding of the event.

Parallel structural dissociation can be more complex than this as well, such as splitting one part for the sights, one for the sounds, one for the physical sensations and one for the emotions. Potentially even more if these different "sub-aspects" of the event are traumatic enough.

In addition to this, there is also sequential parts that hold different "stages" of the event. For example one part for the beginning, one for the "peak" of the trauma, and one for recovering after the fact. You can also have parallel and sequential structural dissociation occurring at the same time, and therefore split multiple sets of EPs for different aspects of the event at multiple different stages of the event.

People with high fragment counts also tend to have a higher number of ANPs as well, due them to the traumatic nature of their lives leading to them compartmentalizing the functions of daily life into much smaller fragments. This occurs in a similar to fashion to what's described above, with multiple ANP fragments fronting at the same time or in quick succession.

As for "dissociation causing it", dissociation is the mechanism behind splitting if that's what you mean. You can't split if you don't dissociate. Dissociation also makes a person more vulnerable to being traumatized, due to it involving constantly low levels of mental energy and efficacy that prevents otherwise allow healthy processing of distressing events.

The chronic flashbacks and internal conflicts experienced by those with structural dissociation may also build up to trauma in some cases, especially combined when with other stressors.

OSDDID spaces online present their experiences very identity-first and everyone always seems to have personal relationships with their alters, like they are their friends or family.

I don't feel connected to them at all, spare for two. Not only this but I don't see them as people either. Just me in different forms stuck in different periods. They still have different "selves": different interests, dislikes, mannerisms, behaviors, and so on, but I still don't see them as "people". I think when it comes down to it I see them purely as symptoms and nothing else. It's taken me a long time to even call them alters at all.

Knowing I have DID at all terrified me, but to see online OSDDID spaces not represent how I experience this makes it all the more lonely.

Yeah, it's pretty common to experience DID in the way you've described. Not to say that alters having relationships with each other or viewing themselves as "separate people" isn't possible, because it definitely does happen. But people online have a tendency to only discuss DID in terms of its most distinct and obvious forms, when in actuality the majority of DID cases present as more subtle and covert.

It's actually healthier not to view alters as separate people, because objectively speaking they aren't and those feelings of separation only reinforce the disorder. It's why the theory of structural dissociation mentions several times that clinicians should not treat alters as separate people and needs to emphasize them as parts of a whole, otherwise the person won't be able to achieve any degree of integration.

I don't mind people acknowledging the fact that alters can believe themselves to be very separate, I take issue with how this presentation is treated as if it's the one true way to experience DID. And with how people insist that such heavy dissociation is actually healthy and doesn't need to be worked on. It very much crosses the line into treating DID like an identity label instead of a serious mental illness, which isn't conducive to anyone's recovery.

When I started therapy, I was firmly treating my parts as solely parts of one whole. They had distinct selves, but they were also just symptoms of my trauma — nothing more. The end goal was for them to solidify into one identity, which was scary since I didn’t know anything else, but isn’t that what being parts of a whole meant?

It worked for us for awhile, but distinctly, we hit a barrier when it came to distancing those parts from their trauma. The ones who viewed themselves more as people had a far easier time, because they were people, capable of growth and change. Not just a symptom or a brain chemistry issue — real breathing people with lives of their own, desires, wants, etc. They just happened to share their body.

One of the parts who struggled the most was our protector, who was stuck distinctly in the mentality that he had to anticipate everything in order to protect us. What helped him grow from that mentality was treating himself with more personhood, acknowledging he could be a person. He developed hobbies and desires separate from the others, as well as hobbies along with the others.

The ISSTD guidelines impress upon therapists and mental healthcare professionals that, while it’s essential that patients don’t believe themselves to be fully separate people — people as in bodies that have no impact on the others — it’s equally essential to use the terminology that the patient most relates to. This is to help improve dissociation and build trust with the therapist, which is required for stabilization before the trauma-processing and integration phases.

But Haze , no one can say it is healthier to treats alters as parts OR separate individuals. Neither is more healthy than the other. It is going to depend on the person/system and what they need and what benefits them best in order to heal without causing distress and roadblocks.

As Sonnet said, professionals are encouraged to use the terminology their patients use. If they see their alters as separate people they should be respecting this and adapting their approach. The reminder to professionals about alters not being individuals is to make sure they understand they need to push home to their patient that they share a singular body and in turn a singular life. The actions, relationships, and choices of one will affect the others. That is what it is saying.

Maybe at one point the idea of alters being only parts and final fusion was the only way you could treat CDDs was the staple at the time. But as more time has passed, and more cases worked with (and people with CDDs have also entered the medical field) it became very apparent that this was faulty and a new approach was encouraged.

Integration is a lot of things, and it can happen in many ways. For some it is seeing themselves as all parts to one whole and not as separate people. Breaking down the divisions between the parts so everything flows together as one with no interuptions. For others it is staying as individuals who work as a team and collaborate to get to the same seamless flow and functionality. It could be something in-between or something else entirely. This is also why I have started to view final fusion and thriving multiplicity as a sliding bar and not an all or nothing end to living with a CDD.

While I agree there is often misunderstandings and misinformation of what dissociation and CDDs are within the community, stating there is only one healthy way be to a system or one proper way towards recovery is also spreading misunderstanding about the disorder. I also agree some people may be pushing themselves further into trouble, but that is ONLY because they do not always see other options available to them. They may not have a reliable support system or a professional to help them when things go overboard. It isn't the choice of being individuals, or the dissociation that sometimes comes with it, that is necessarily the bad thing in this scenario. It is that they do not understand themselves, their system, or their mental health enough to take all factors into play (and as an outside party neither can we). And truthfully, everyone is allowed to take that risk. That is their choice, their means of finding out what works or doesn't.

As a community it isn't our job to say what someone should or shouldn't do just because we think its best or has been personally beneficial. The reason I would love to see more pwCDDs that do not see themselves, or work, as individuals share their experiences is because then more of us would understand both sides of the coin (plus you deserve the chance to share your experiences). We could see someone struggling and suggest a different route. People encourage and support their own experiences, and as a community I think it is important to understand that our way of existing and healing isnt going to work for everyone. What is safe for us isn't guaranteed to be safe for another. What we do to integrate, handle dissociation, dysphoria, trauma, etc isn't going to be the same for everyone.

This is literally exactly what I'm saying.

And I'm aware professionals are encouraged to use the languages their clients use, I'm not saying you literally have to call them "parts" if you don't want to. What I'm saying is that the core of the disorder is dissociating away from parts yourself and disavowing them as different people or entities, and you are never going to heal from a disorder if you are just constantly reinforcing the core of what makes you sick.

You have to strike a balance with DID treatment. Alters need to be acknowledged and engaged with as they are, you should not be ignoring them or trying to "get rid" of them. But as I've said, doing the complete opposite of that is harmful as well.

Integration refers to processing your memories, personality and identity as all being part of one cohesive whole. Dissociation refers to the separation of these parts and the disavowal of them as being part of the same whole. There is no way to achieve integration while still dissociating at the same time, they are opposite processes.

I'm not saying there is only one way to recover from DID, because as you said how integration presents exactly can vary from person to person. But all integration involves processing dissociative parts as being parts of a whole. That is quite literally the definition.

Claiming that pointing that out is to say there's only one way to heal from DID, is like claiming that "you need to eat to recover from a restrictive ED" is also saying there's one way to heal. There is variation in recovery, but you always need to address what's at the core of the disorder.

A few excerpts from the Haunted Self that I was referring to here:

"Even though dissociative parts have a sense of self, no matter how rudimentary, they are not separate entities, but rather are different, more or less divided psychobiological systems that are not sufficiently cohesive or coordinated within an individual’s personality...These systems are part of a single human being, so we have chosen to refer to the entire individual when he or she is directed by one of those unintegrated systems."

The degree of emancipation of parts varies. Some have a depersonalized awareness that they are part of a larger personality: “I know I’m part of him, but it doesn’t feel like it.” Others realize this only vaguely, and a few regard themselves as an entirely separate person, even when confronted with obvious evidence to the contrary. This can lead to serious problems for survivors.

Various ANPs and EPs may have a strong investment in the belief that they are separate persons. This substitute belief must be met with gentle but consistent challenges by the therapist. If parts insist on being called by another name, the therapist may do so, but also should regularly refer to such parts as aspects of a whole person.