This is the void I scream into about schizoid personality disorder, dissociation, trauma, and other mental health related things. I mainly post to try to correct misinformation and provide access to scientific resources within these communities. Feel free to ask questions or request resources on specific topics.
Tags include: #haze posts for original posts, #asks for answered asks, #info for informational posts, #resources for links and excerpts of psych resources, studies, reviews, etc. #quotes and #images are self-explanatory.
Stances and such under the cut. I have no DNI (especially not for informational posts), just know that these stances are non-negotiable and I do not want you to try to convert me. I can guarantee I've already heard whatever argument you think will change my mind before anyways, I've been around mental health discourse for a long time.
Anti-endo
Alters are highly complex dissociative compartmentalizations of traumatic memory; they are dependent on PTSD to exist on a neuropsychological level. Endogenic ideology comes from pseudoscientific anti-DID hate groups, and the things people label as "endogenic" are either explained by normal human experiences or other mental disorders. There is no proof that alters (or any form of "self states" that are distinct, autonomous and non-transient) can exist without trauma, and there is over a century's worth of proof that they cannot.
More details: 1, 2, 3, 4, 5
Pro-recovery and Anti-misinformation
If you view alters as "multiple people in one body" or "friends in your head", oppose integration (including fusion, source separation and alters becoming less distinct), and/or treat DID like a fun game or quirky lifestyle instead of a serious trauma disorder, you probably won't like much of what I have to say here.
Psych critical
I am critical of the mental healthcare system, but still pro-science, pro-diagnosis, pro-psych medication, pro-psych hospitalization, etc. I don't like misinformation or demonization of mental healthcare under the guise of "criticism", which tends to be unfortunately common in full on anti-psych spaces. It does way more harm than good, and you can address the problems within the system without playing into mental health denialism and anti-intellectualism.
Anti-demonization
I have zero tolerance for the demonization of trauma-based disorders and symptoms such as avoidant attachment, empathy deficits, NPD, ASPD or whatever else people have decided the "evil" mental health condition is. You're not going to find sympathy for those viewpoints with me, so don't even bother.
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This is going to be a longer post, because I keep seeing misinformation about this over and over, but it's not something that can be explained fully in a small number of words.
This post is about the requirements of DID development, and specifically why it is not true that DID can develop in response to any negative experience if the child's stress tolerance is low enough.
Other sources will be included when relevant, but most of this comes from the theory of structural dissociation through The Haunted Self.
The basics
In short, DID can only develop in response to complex trauma before the age of 6, up to about 8 at the latest. To be more specific, DID requires the child to experience multiple severe, prolonged and varied traumas involving betrayal or abandonment from their primary caregivers. A genetic predisposition to dissociation is also required, but that isn’t as relevant to this post.
When does the personality integrate?
Most people are aware that DID has to develop before the personality has fully integrated, which happens in early childhood. There isn’t an exact set age for when this happens, as psychological development is variable and hard to measure.
However, people will often claim that it happens far later than it actually does. To understand why this is wrong we have to understand what we actually mean when we talk about the personality integrating.
The human personality is made up of several different psychobiological systems of mental and physical actions we can take in response to our environment, and our understanding of those actions in relation to ourselves and the world.
These systems represent different functions of personality, such as attachment, self-care, exploration, reproduction, defense from threats, etc. There are multiple subsystems within these broader systems as well.
These systems maintain themselves through the continuous integration of the experiences had within these domains. If this integration fails, their cohesive functioning will falter and dissociation may develop (as dissociating away from the memories held within these systems will naturally cause the systems themselves to dissociate away from each other as well).
Both dissociation and integration are active processes, they must continuously maintain themselves and they will turn into the other if they fail to do so.
In a healthy adult, these personality systems function fluidly and cohesively, neither fully open nor fully closed to each other. They allow the person to seamlessly transition between different aspects of their personality as required, and create a base for a consistent identity to form on top of (which begins in late childhood and adolescence). It is not true that these parts all fuse into one singular entity; they simply come to achieve a basic level of cohesion that cannot be fully undone afterwards.
In early childhood, these parts still function quite rigidly. In order for them to achieve this baseline level of integration, the child needs to continuously process the experiences they have within these domains, and be able to make sense of them in relation to each other. This is a long process that makes up the majority of the psychological development of early childhood.
A child with an unintegrated personality will experience their personality systems separately, and will not be able to seamlessly transition between them. This is why young children seem so all over the place.
For example, a younger child may be happily playing by themselves one minute, and then screaming and crying for their mother the next. This is because the personality functions of exploration (subfunction: play) and attachment (subfunction: attachment cry) have not yet integrated, and therefore they cannot function fluidly.
An older child may instead quietly put down their toy and go to find their mother, because those two personality systems have been integrated. This is why the estimates for the exact age of when the personality integrates keep getting younger as the research progresses. Because how many children do you know above the age of 7 or 8 that function like the former instead of the latter?
For DID to develop, there must be a total failure in the integration of these systems due to the structural dissociation of traumatic memory preventing them from being processed as part of a cohesive whole.
And as we have established, dissociation is an active process. One singular instance of dissociation is not enough to prevent the integration of the personality systems. In order for them to be as separated as required for the development of DID, heavy dissociation must be maintained before these parts are expected to achieve full integration.
As such, the trauma (and resulting dissociation) must be prolonged before the age of around 6 to 8. Otherwise, the child will have made too much progress towards integration and not enough towards dissociation in order to form alters (although other trauma disorders are still a possibility). You can see this in the fact that on average, people with DID can trace back their first appearance of alters to around age 6 as stated here.
“The typical patient who is diagnosed with DID is a woman, about age 30. A retrospective review of that patient’s history will typically reveal...emergence of alters at about the age of 6”
To form noticeable alters, the person must have already experienced prolonged dissociation. Therefore, in order for the average patient to have alters emerge at age 6, their dissociation must have already been prolonged by that point, and the multiple traumas that caused said dissociation must have started significantly earlier. This is why the trauma itself starts at least before the age of 5-6, and often in infancy or the early toddler years.
From the DSM-V:
“In the context of family and attachment pathology, early life trauma (e.g. neglect and physical, sexual and emotional abuse, usually before ages 5–6 years) represents a risk factor for dissociative identity disorder."
From here (again):
“Putnam and his colleagues propose that DID arises from traumatized children’s inability to form a cohesive sense of self, leading to the emergence of alternate identities. This phenomenon is especially apparent when traumatic experiences occur before the age of 5.”
And from The Haunted Self:
“The older the child is prior to abuse and neglect, the more likely action systems of daily life have become more cohesive, and thus it is less likely that more than a single ANP would develop.”
This is why things such as bullying are very unlikely to cause DID on their own (although they may be a part of the person’s overall trauma history). That would require preschool children to be able to bully someone to the severity necessary to develop DID (more on that later), as any older age group would be too late to create the necessary degree of separation before the age of integration is reached.
Therefore, the complex trauma needs to occur long before the age of 6–8, almost always before the age of 5–6.
What is complex trauma?
The definition of complex trauma can vary slightly from source to source, but it is most consistently defined as experiencing multiple severely distressing events that are repeated and prolonged, involve betrayal or abandonment from primary caregivers, and occur at developmentally sensitive time periods.
See the following definitions, sourced from here:
“We define complex psychological trauma as resulting from exposure to severe stressors that (1) are repetitive or prolonged, (2) involve harm of abandonment by caregivers or other ostensibly responsible adults, and (3) occur at developmentally vulnerable times in the victim’s life, such as early childhood or adolescence.”
And here:
“Complex trauma describes both children’s exposure to multiple traumatic events—often of an invasive, interpersonal nature—and the wide-ranging, long-term effects of this exposure. These events are severe and pervasive, such as abuse or profound neglect. They usually occur early in life and can disrupt many aspects of the child’s development and the formation of a sense of self. Since these events often occur with a caregiver, they interfere with the child’s ability to form a secure attachment.”
It is important to contrast complex trauma from the other two classifications of trauma: acute and chronic. They are defined as follows:
Acute: a singular, isolated traumatic event that engages a short-term sympathetic nervous system response. Includes one-off physical or sexual assault, natural disasters, accidents, etc.
Chronic: a prolonged or repeated experience of a traumatic event that engages a more long-term sympathetic nervous system response. Includes experiencing one type of prolonged abuse, prolonged medical trauma, etc.
More details here.
Acute and chronic trauma cannot cause DID, and neither can regular stressors (more on that in the next section). Low stress tolerance also cannot make acute or chronic trauma “turn into” complex trauma; they are distinct phenomena. Complex trauma always requires the experience of multiple different prolonged traumas involving betrayal or abandonment from primary caregivers.
It is important to note that while severity of trauma is subjective, complexity of trauma is not. Perceiving a non-complex trauma as being more severe than an average person would does not transform that experience into complex trauma.
Why is complex trauma required for DID?
DID exists on what is called the tertiary level of structural dissociation. Structural dissociation refers to the abnormal dissociative compartmentalization of traumatic memories, which leads to a divide between the personality systems of daily life and defense from threats (and in more complex forms; the division of these systems within themselves).
The resulting divisions are apparently normal parts (ANPs) who do not contain traumatic memories and instead handle daily life, and emotional parts (EPs) who contain traumatic memories and the resulting emotional and behavioural responses.
There are three levels of structural dissociation that are cumulative, meaning they each build off the level that precedes them:
PTSD is on the primary level of structural dissociation, involving one ANP that comprises the majority of the personality and a rudimentary EP that holds the traumatic memory (which is usually acute, sometimes chronic). The separation between these parts is minimal.
C-PTSD and trauma-based personality disorders are on the secondary level, involving one ANP that still compromises most of the personality, but several EPs that may be slightly more elaborated than in PTSD. This occurs when a person experiences multiple traumas that are too distinct for them to be contained in one EP, or when a repeated/prolonged trauma increases in severity in later instances and the existing EP’s threshold for re-traumatization is crossed. This causes the EP to structurally dissociate away from those experiences, creating another.
DID is on the tertiary level, involving multiple ANPs and multiple EPs that have a high degree of complexity and separation from each other. This is caused by multiple severe traumas necessitating the creation of multiple EPs, and the trauma being so integrated into daily life at such a young age that daily life itself becomes traumatic, necessitating multiple ANPs.
This means that in order to develop DID, the person must be pushed past the point of developing both PTSD and C-PTSD. They need to experience multiple different traumas to structurally dissociate their subfunctions of defense and create multiple EPs, and said traumas need to be extremely pervasive in daily life from a very young age in order to structurally dissociate their subfunctions of daily life and create multiple ANPs.
From The Haunted Self:
“Various traumatizing events may induce different sets of EPs. Each group of EPs usually experiences and contains traumatic memories related to a specific cluster of traumatic experiences. Groups of EPs are most often seen in tertiary structural dissociation, as DID patients tend to have experienced the most severe and multiple traumatizing events.”
“We hypothesize that the origins of the divisions among ANPs lie in the inability of an unsupported, emotionally neglected, and abused child to integrate emerging action systems of daily life when various aspects of daily life themselves are chronically traumatizing.”
For these parts to reach the level of distinction necessary for DID, multiple types of trauma must occur. This is because multiple instances of the same trauma will simply be contained within the same EP due to the experiences being compatible with what that EP already holds; the creation of a new one needs to push beyond that.
From The Haunted Self:
“Development of EPs over the course of time in chronic traumatization perhaps indicates a lowering of mental level for the previous part of the personality, such that another dissociative part is formed.”
Note that there are multiple experiences that come under the same broad classifications of trauma that may differ from each other significantly on a practical level. For example, being intentionally starved and being hit both fall under physical abuse, however the human mind will likely process them as two distinct events and therefore split two EPs.
Additionally, ANPs and EPs gain complexity through life experience, specifically from the experiences they are triggered out to handle that other parts are amnesiac for. ANPs and EPs who remember different instances of the same events with minimal differences between them will not be presented with the opportunity to develop distinct traits.
Obviously, some alters within DID may be similar because of this (i.e. fragments), but at least some alters must be distinct in order to meet the criteria.
From the Haunted Self:
“Elaboration is concerned with the complexity of a dissociative part’s repertoire of actions, including memory, skills, and sense of self. It is developed when a dissociative part is regularly exposed to external reality or a rich internal reality.”
“Children who are abused and neglected by their caretakers in early childhood, with maltreatment constituting a substantial part of daily life, will probably have particular difficulty in developing normative daily life systems. This is a common experience of DID patients. These children must alternate so quickly and frequently among emerging defensive and daily life action systems that these systems, hence their EPs and ANPs, can become mixed in quite chaotic manifestations.”
There is also an entire section of The Haunted Self that goes into all of this in much more detail, called “The Origins of Secondary and Tertiary Structural Dissociation”, found in chapter 4.
Essentially, your brain cannot just create multiple distinct ANPs and EPs because it “feels like it” or due to any form of stress. It needs to be continuously and severely traumatized in distinct ways that are integrated throughout daily life. Otherwise the person will not develop beyond primary or secondary structural dissociation. Your brain cannot simply skip to the tertiary level without first being pushed beyond the previous two levels.
What is disorganized attachment?
Disorganized attachment is also required for the development of DID and makes up the “betrayal or abandonment from caregivers” aspect of complex trauma. It refers to inconsistent and contradictory behaviour displayed by a child towards their caregiver, where neither separation nor closeness feels safe. This is often the result of abusive or neglectful parenting.
From The Haunted Self:
“However, what happens when caretakers manifest frightened, hostile, or helpless behavior toward their children? When such behavior is a pattern, a particular attachment style develops in infants (i.e., disorganized/disoriented attachment or D-attachment) ...D-attachment describes the unusual approach-avoidance response patterns of an infant toward a caregiver who should be the source of safety and security, but is also simultaneously the source of fear and threat.”
And from here:
“Developmental models suggest that when caregivers are abusive, frightening, or insensitive, children experience an irresolvable inner conflict of flight and approach, leading to disorganized attachment.”
Why is disorganized attachment required for DID?
Secure attachment (i.e. where the child feels that their primary caregivers are safe and dependable) is key to the integration of the personality systems in early childhood.
Young children are reliant on their caregivers to regulate them and model healthy behaviour as they begin to understand the world around them and their own identities. Therefore, when attachment is instead disorganized, the child’s ability to integrate their personality systems and subsystems is severely inhibited.
Specifically, the contradictory nature of disorganized attachment is important to this. The memories associated with personality systems need to be cohesively processed together in order to foster their integration. As such, when caregivers are extremely unpredictable and threatening, confusion develops between these systems as their respective memories are incompatible.
For example, the personality system of energy regulation experiences the caregivers as being the source of food, but the personality systems of attachment and defense see the caregivers as the source of threat.
There may also be confusion between the subsystems of individual personality systems as well, such as the system of energy regulation receiving food from the caregivers on some occasions and being starved by them on others.
As these conflicting ideas of the caregivers all across life cannot be integrated together, they must instead be structurally dissociated from each other.
From The Haunted Self:
“The young child’s personality is relatively unintegrated, and integrative structures of the brain are still immature (Perry & Pollard, 1998; Teicher, Anderson, Polcari, Anderson, & Navalta, 2002). The quality of the first years of life, particularly secure attachment, is instrumental in laying the groundwork of a personality organization that is rather cohesive across contexts, such as action systems, place, time, and sense of self.”
“[The development of DID is related to] ...degree of social support, including attachment relationships; disruption of the normal integration of the child’s action systems that requires a secure attachment relationship.”
And from here (again):
“Meta-analytic evidence confirms that childhood maltreatment profoundly disrupts attachment organization and predisposes to disorganized attachment...Recent conceptualizations of “attachment trauma” postulate that childhood maltreatment triggers distinct pathogenic processes, such as traumatic disintegration, detachment, and dissociation, which may contribute to identity disturbances.”
As disorganized attachment is so central in the development of identity pathology, achieving the degree of identity disturbance necessary to form DID, the most severe form of disordered identity, in the absence of disorganized attachment is not possible. This means that a healthy caregiver-child relationship is a direct contradiction to the requirements of DID development.
Therefore, it is not possible to develop DID without disorganized attachment. This does not necessarily mean that one’s primary caregivers must be irredeemable monsters to form DID, but that they must commit betrayal and/or abandonment against the child that leads to the child’s mind being unable to process them as a safe presence. As such, it is impossible for a person who had a good relationship with their caregivers in childhood to form DID.
Can trauma other than abuse cause DID?
Technically yes, but there’s a reason why this isn’t common.
Really, this depends on how you define “abuse”. As we have established, DID requires disorganized attachment resulting from betrayal and/or abandonment from caregivers in order to develop. As a result, there must be at least a partial interpersonal aspect to the trauma that causes DID.
Even if the caregivers did not outright abuse the child, at a minimum they must have neglected the child to a degree where they could not view them as safe figures. Many people argue that such a level of neglect is abuse in and of itself, and under that understanding abuse must be involved for DID development.
However, as we have also established, the caregivers themselves do not need to be severely abusive in order for the child to form DID. The child must feel that they are undependable and unsafe, but the multiple severe and prolonged traumas may come from elsewhere (note that this disorganized attachment forms part of the trauma and of itself, it just cannot cause DID alone if the circumstances that led to it do not meet the requirements of “multiple severe prolonged traumas”).
For example, some people with DID had neglectful or absent parents, and then experienced multiple forms of severe abuse from other family members or other trusted people (again, while absent caregivers are traumatic within their own right, the point is that the “worst” of the trauma does not necessarily have to come from the caregivers).
This can apply to traumas other than abuse as well. For example, medical trauma in which a child is experiencing multiple distinct traumatic events (such as different kinds of distressing and painful medical procedures or episodes) can result in DID if it occurs young enough and disorganized attachment is present.
You can interpret this one of two ways:
Neglect is a form of abuse and therefore DID development requires abuse, although said abuse does not need to be the “main trauma” so to speak
DID development does not require outright abuse, but at the very least neglect is required
All in all, due to the fact that DID requires disorganized attachment to primary caregivers, and that the trauma needs to begin at an age where the child is primarily living at home (before the age of around 6, therefore before school-age), the vast majority of DID cases are caused by intrafamilial abuse.
Again, other circumstances are technically possible, but due to the nature of the requirements, other forms of trauma are much more likely to result in other disorders.
From the DSM-V:
“In studies from diverse geographic regions, about 90% of the individuals with the disorder report multiple types of early neglect and childhood abuse, often extending into late adolescence. Some individuals report that maltreatment primarily occurred outside the family, in school, church, and/or neighborhoods, including being bullied severely. Other forms of repeated early-life traumatic experiences include multiple, painful childhood medical and surgical procedures; war; terrorism; or being trafficked beginning in childhood.”
And from here:
“The authors interviewed 102 individuals with clinical diagnoses of multiple personality disorder at four centres using the Dissociative Disorders Interview Schedule. The patients reported high rates of childhood trauma: 90.2% had been sexually abused, 82.4% physically abused, and 95.1% subjected to one or both forms of child abuse.”
Keep in mind that these figures rely on self-report, and true numbers are likely higher due to the amnesia, shame, and nonrealization of trauma commonly experienced by DID patients.
In conclusion
DID is a specific trauma response with specific requirements; it cannot develop in response to any negative experience that a child experiences, regardless of their stress tolerance. It is specifically a complex trauma-based disorder, caused by experiencing multiple severe and prolonged traumatic events involving betrayal or abandonment from primary caregivers, before the age of around 6 years old.
This does not mean that other forms of trauma “aren’t bad enough” or aren’t debilitating; they absolutely are. This simply means that those forms of trauma will likely result in other disorders and not DID.
DID is not “the disorder that you get when your trauma was bad enough”. It’s the disorder you get when you meet the requirements of developing it, and whether or not you have it has no impact on the validity of your trauma or suffering.
If you believe yourself to have DID when that wouldn't be possible based on your current understanding of your trauma history, that needs to be handled by a professional. It's possible you don't remember your full history or haven't realized your experiences do qualify, or it could be that your self-diagnosis is wrong.
Either way, spreading misinformation on the internet is not how this should be handled and you are not helping anyone by doing so, let alone yourself.
I understand the hesitance people have towards speaking about the requirements of DID development, but there is no situation in which misinformation is helpful to anyone.
Why do I see so few endo systems online? I see a lot of pro-endo did/osdd blogs, but never the endos themselves and I was wondering why
They're definitely around, but I guess it might have something to do with the whole idea being a pretty obscure branch of pseudoscience. I'd say that DID in general is still a relatively niche topic in the grand scheme of things, so the amount of people who actually identify with the concepts invented in response to DID by a small anti-science corner of the internet isn't likely to be too large.
I think the debates around this kind of stuff tends to gain more traction than the ideas themselves. The whole "polymind" thing might be a similar example, there were months of heated discourse about that and yet I can genuinely count the amount of people I saw actually identifying as "polyminds" on one hand.
I personally think part of the reason why the "endo" thing has remained within the discourse for so long is because it's so closely related to other controversial topics. A lot of pro-endo people also tend to believe in a lot of other anti-recovery and anti-science misinformation (such as alters being separate people, DID being an identity or subculture, fusion and integration being bad, etc).
So people aren't really arguing just about "endos", they're arguing about an entire viewpoint surrounding systemhood. Essentially it comes down to whether you view it as a legitimate scientific concept or as an online label for people to identify with.
For anyone who is confused, yes, schizoid personality disorder and autism can occur together.
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
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used to think everyone was exaggerating every reaction ever especially on the internet to the point where even now when i see someone post something excitedly i have to remind myself that it may be their entirely genuine reaction and they arent just saying that
years ago i got into so many arguments saying diagnosis itself isn't a privilege. it can be a manifestation of other privileges (e.g. rich, white, educated, country of residence) but by itself it is just one aspect of a larger system and what you really want is proper healthcare, which is not the same thing as a diagnosis. also be real. no aspect of being disabled - an oppressed class - is a privilege. and i was right
I just wanted to say thank you. Your posts explain DID in a clear, scientific way without romanticising it. It's so difficult to find information that is both accurate and understandable, and your blog has been genuinely helpful.
No problem, that's all I'm really trying to do here. It's good to know that these posts have been helpful for people.
i think some of u are kinda shitty towards systems with low headcounts.
i get high headcounts are... DIFFICULT. but for the love of god please stop putting down other systems at your own expense. it fucks us up really bad that just because there's less of us, people think we "have it easy".
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Small reminder that DID is often a covert disorder and overt DID is actually pretty rare. A person could go their whole life without knowing they have DID because that's the point. You do not need to know who you are all the time or who's fronting or need to feel like you're a faker because you act the same pretty much all the time. You do not need to act drastically different between your headmates to be valid.
Hello! I hope you are doing well.
I was wondering if you happened to know any references that explain if the experience of limb weakness / loss of muscle memory during certain skill based activities can be a symptom of any conditions unrelated to CDDs? Or, lower tiers of structural dissociation? I do have OCD and C-PTSD, and I'm in therapy for those -- currently trying to figure out if its something worth bringing up in a dissociative context with my therapist.
Thank you so, so much for any insight / references. Your blog and the effort you've put in to gathering science-based resources here have been a huge help + comfort. Wishing you the best!
Loss of muscle memory could be explained by skill regression in CDDs, which is a relatively common experience. It can also be benign (such as a response to regular stress) or a part of some physical health conditions. It also can potentially occur on the lower levels of structural dissociation such as C-PTSD.
From the DSM-V section on DID:
"Dissociative amnesia (Criterion B) manifests in several major domains: 1) gaps in any aspect of autobiographical memory (e.g., important life events like getting married or giving birth, lack of recall of all school experiences before high school); 2) lapses in memory of recent events or well-learned skills (e.g., how to do one’s job, use a computer, cook or drive); and 3) discovery of possessions that the individual has no recollection of ever owning (e.g., clothing, weapons, tools, writings or drawings that he or she must have created)."
From The Haunted Self (theory of structural dissociation):
"Loss of skills not only involves the absence of certain mental actions, but also of behavioral actions. When EP has complete executive control, the daily life skills of ANP are often missing. Thus, survivors as EP commonly report that they have no idea how to cook, take care of children, or perform work duties, and generally feel inadequate and overwhelmed with the tasks of daily life because they do not have access to needed skills for periods of time."
As for limb weakness, that may have something to do with functional neurological symptoms, which can be associated with trauma and dissociation (which used to called "conversion symptoms" and is now commonly called "somatoform dissociation"). It can be an associated feature of CDDs but it's not exclusive to them.
From the DSM-V section on DID comorbidity:
"The most common forms of functional neurological symptom disorder include nonepileptic seizures, gait disturbances, and paralyses. Most commonly, nonepileptic seizures resemble grand mal seizures or complex partial seizures with temporal lobe foci; others may mimic absence or partial seizures."
And from The Haunted Self again:
"Temporary or more permanent loss of motor control includes partial or total paralysis of limbs or the entire body, contractures, physical lack of coordination, cataplexy (i.e., a sudden and general loss of muscle tension)... These symptoms are often dissociative in nature and can be trauma related...
With regard to freezing, patients report being unable to move while still feeling extremely fearful and hypervigilant...In this condition survivors’ muscles become flaccid and sometimes they temporarily may remain in fixed positions."
So while these things can be a part of CDDs, they can also appear in less complex structural dissociation and also other health conditions. I'd say it's worth bringing up to a medical professional.
Some studies that may be helpful:
Dissociation and its biological and clinical associations in functional neurological disorder: systematic review and meta-analysis
Dissociation and interoception in functional neurological disorder
Cortical thickness alterations linked to somatoform and psychological dissociation in functional neurological disorders
Toward a possible trauma subtype of functional neurological disorder: impact on symptom severity and physical health
Somatoform Dissociation: Major Symptoms of Dissociative Disorders
Degree of somatoform and psychological dissociation in dissociative disorder is correlated with reported trauma
Somatoform Dissociation, Psychological Dissociation, and Specific Forms of Trauma
Somatoform dissociative symptoms as related to animal defensive reactions to predatory imminence and injury
Glad you've found the blog helpful, wishing you the best with your recovery
Reminder that alters can only split from trauma. Alters are highly complex dissociative compartmentalizations of traumatic memory that are reliant on PTSD in order to exist on a neuropsychological level. Your brain cannot compartmentalize a trauma memory if there is no trauma memory to compartmentalize.
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.
Saying that alters can split without trauma because of stress is misinformation, because the entire point of the window of tolerance is that it is easier to become traumatized when in a state of chronic stress.
So how many times did we get traumatized if we have fragments in the billions just hanging out here
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.
I saw someone say in a study dissociation causes it too. How is dissociation traumatizing? Isn’t that the coping mechanism? So I’m curious on your thoughts on that
In short: a single traumatic event can cause a person to split more than once if the event is severe enough and the person's distress tolerance is low.
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.
You know, I really don't like how much of "syscourse" is actually just grown adults intentionally misrepresenting scientific literature and making fallacious arguments to teenagers who are too young to realize that's what they're doing.
Are you "owning the anti-endos" or are you just trying to publicly humiliate a literal child with arguments that would be get you laughed at if you made them in an actual academic setting?
Honestly, if you're a minor you should probably just block any adult who comes onto your blog unprompted to debate you about this stuff. An adult who's looking for a productive conversation won't seek out a child for that. An adult who's looking for an inexperienced target to embarrass in order to make the opposing viewpoint look stupid will, though.
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You know, I really don't like how much of "syscourse" is actually just grown adults intentionally misrepresenting scientific literature and making fallacious arguments to teenagers who are too young to realize that's what they're doing.
Are you "owning the anti-endos" or are you just trying to publicly humiliate a literal child with arguments that would be get you laughed at if you made them in an actual academic setting?
I tend to avoid online spaces but this specific thing has been bothering me for a long time.
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.
And the end result of all of this is that people with the most common presentations of DID do not feel understood within what is supposed to be their own community, which is a shame.
Hey Anon! I just wanted to offer a somewhat different perspective, as someone who’s made a lot of progress in 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.
As someone in the integration phase of therapy, I think it’s vital for you to develop your own outlook on your system and what labels you use. Maybe being parts of a whole suits you the best!! Maybe seeing them as people will help instead. There’s no harm in trying what you can to help lessen the barriers between your parts. Whatever works, works.
Anon, I would also love to see more people sharing experiences like yours.
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.
A lot of professionals keep to what they know. Sometimes this means they will not adapt to their patient's needs. But just because they stick to one way of doing something does not mean that is the right or only way.
"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."
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.
I hope this better illustrates what I'm talking about, because I really don't think we disagree.
