#df-jake

Let’s start at the basics: the criteria for DID according to the DSM-5. According to webmd.com, to diagnose DID, the patient must have:

“Two or more distinct identities or personality states are present, each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self.

Amnesia must occur, defined as gaps in the recall of everyday events, important personal information, and/or traumatic events.

The person must be distressed by the disorder or have trouble functioning in one or more major life areas because of the disorder.

The disturbance is not part of normal cultural or religious practices.

The symptoms cannot be due to the direct physiological effects of a substance (such as blackouts or chaotic behavior during alcohol intoxication) or a general medical condition (such as complex partial seizures).”

Points 4 and 5 focus on religion and drug use, which are going to be ignored for the sake of this analysis. It’s the first three points that play a key role in the diagnosis of DID, OSDD-1, and DDNOS. 

Working backwards: point 3 says that the system’s plurality must be disordered to have the diagnosis. Therefore, any form of functional plurality is excluded from the diagnosis; despite this, functional multiplicity is often the goal of extensive therapy when diagnosed with a dissociative disorder. The reversing of the third point of the diagnosis is often the goal of treatment. However, when people state they want to reach full integration to obtain functional multiplicity, it’s often misunderstood. Integration is the process by which the amnesiac barriers between system members lower and communication between members strengthens, whereas fusion is the process where system members merge into one whole piece, essentially turning a system into a singlet over time (source 1, source 2, source 3). You may be able to tell that by achieving functional multiplicity, amnesia is lessened, following the reversing of point 2. 

If we break up the previous paragraph, we can come up with a diagnostic criteria and treatment for plurality using the first three criteria: 

DID is diagnosed when a person shows multiple identity states[1] that suffer with amnesia between them[2], resulting in heavy distress in their life[3]. 

Functional Multiplicity, which is achieved through integration (the lowering of amnesia barriers[2]), can lead to less distress[3] in a system’s life as their identity states work in better harmony[1]. 

Comically, none of the criteria itself uses the word “dissociative”, though the avenue of it will be pursued due to being in the name of the disorder. In traumagenic systems, yes, the dissociation is brought on by severe trauma. But what about endogenic systems who are diagnosed with DID? In these cases, it’s more likely that their system started spontaneously, naturally, or from some other cause; however it came about, originally, they were not distressed. A severe stressor happened later in life for these diagnosed endogenic systems: while that could be them encountering trauma, it could also be the stress of any natural disaster (or, in recent times, a certain pandemic). Dissociation could also happen as a result of anxiety or another mental illness. Dissociation itself is a coping mechanism for any stressor, and it’s important to know that, while trauma counts as a stressor, not all stressors equate to trauma.