#part fred

The thing about people who don't think that Complex Dissociative Disorders are trauma disorders is that they seem to think that researchers just saw the first connection on the board (dissociation being connected to trauma) and automatically assumed with no other evidence or research into other options that Complex Dissociative Disorders are only trauma disorders. They think that researchers and professionals didn't look into other options first before deciding that Complex Dissociative Disorders are trauma disorders.

This is an absolutely insane notion that people seem to believe and this belief is evidenced by people only having read parts of the DSM, seeing that DID is in the dissociative disorders section rather than the trauma and stressor related disorders section, and by them claiming that other options haven't been explored.

This is false. Below are screenshots of citations of 18 different papers that I gathered on the subject of alternate causes for complex dissociative disorders and/or otherwise looking into the general phenomenology/epidemiology of complex dissociative disorders.

I gathered all of these sources from looking at two papers that examined complex dissociative disorders and the empirical evidence behind them and/or disproving common myths about DID, such as it being a disorder unrelated to trauma. Imagine how much more I could find if I expanded my looking into this subject into the references sited by the papers I mention here.

Researchers have tried to look for other causes for DID, for a variety of reasons from not believing in the existence of DID, wanting to cover their bases, or not believing that trauma could be this severe and prevalent towards children.

The verdict in the end is that the other theories don't hold up to the clinical evidence gathered over the course of decades.

Non-traumagenic DID is not possible. There is no reason for one to dissociate to such an extent that they have to disown their own life experiences repeatedly until the consciousness divide between the life experiences they do own and the ones that they disintegrate become separate identities.

At its core, pathological dissociation is a failure of integration of life experiences. This happens due to intense stress and trauma that a person experiences, and when they experience this stress and trauma during the formative experiences of their lives (i.e. childhood), these deeply traumatic and formative experiences are so unacceptable to them that there is no way for them to integrate these events into their autobiographical memory and sense of self, and have to say that these experiences happened to someone else: to someone who deserved it, to someone who could handle it, to someone who likes it, to someone who can't feel it, etc.

Alternatively, as a protection mechanism and/or an internal self self harm mechanism, they can own the actions of people perpetuating abuse against them and form an internal identity that is based around the perpetrators so that the trauma/abuse doesn't happen more, or to have some kind of internal control over their trauma/abuse.

They also form identities that do not remember, own or aren't affected by the memories of the trauma so that they can continue on in daily life with minimal effects from the trauma, where these parts may disown, try to disprove or otherwise heavily avoid the trauma, triggers for the trauma memories, or anything else that reminds them of the trauma.

This is how complex dissociative disorders cannot be anything other than trauma-based in nature. They are caused by trauma, and primarily exhibiting the symptom of dissociation to various extents.

Dissociative Identity Disorder is a trauma-based disorder, end of.

Further Reading:

“Boysen GA, VanBergen A. A review of published research on adult dissociative identity disorder: 2000–2010. J Nerv Ment Dis 2013;201:5–11” (Brand et al., 2016, p. 268)

“Şar V. Epidemiology of dissociative disorders: an overview. Epidemiol Res Int 2011;2011:404538” (Brand et al., 2016, p. 268)

“Brand B, Loewenstein RJ. Dissociative disorders: an overview of assessment, phenomenology and treatment. Psychiatr Times 2010 (Oct);27:62–9” (Brand et al., 2016, p. 267)

“Ross CA, Miller SD, Reagor P, et al. (1990b) Structured interview data on 102 cases of multiple personality disorder from four centers. American Journal of Psychiatry 147: 596–601.” (Dorahy et al., 2014, p. 416)

“Ross CA (1997) Dissociative Identity Disorder: Diagnosis, Clinical Features, and Treatment of Multiple Personality. New York: Wiley.” (Dorahy et al., 2014, p. 415)

“Rodewald F, Dell PF, Wilhelm-Gößling C, et al. (2011a) Are major dissociative disorders characterized by a qualitatively different kind of dissociation. Journal of Trauma & Dissociation 12: 9–24.” (Dorahy et al., 2014, p. 415)

“Reinders AATS, Nijenhuis ERS, Quak J, et al. (2006) Psychobiological characteristics of dissociative identity disorder: A symptom provocation study. Biological Psychiatry 60: 730–740.” (Dorahy et al., 2014, p. 415)

“Putnam FW (2006) Dissociative disorders. In: Cicchetti D and Cohen DJ (eds) Developmental Psychopathology, Volume 2. New York: Wiley, pp. 657–695.” (Dorahy et al., 2014, p. 415)

“Myrick AC, Brand BL and Putnam FW (2013) For better or worse: the role of revictimization and stress in the course of treatment for dissociative disorders. Journal of Trauma & Dissociation 14: 375–389.” (Dorahy et al., 2014, p. 415)

“Middleton W and Butler J (1998) Dissociative identity disorder: An Australian series. Australia and New Zealand Journal of Psychiatry 32: 794–804. Modestin J, Ebner” (Dorahy et al., 2014, p. 415)

“McDowell DM, Levin FR and Nunes EV (1999) Dissociative identity disorder and substance abuse: The forgotten relationship. Journal of Psychoactive Drugs 31: 71–83.” (Dorahy et al., 2014, p. 415)

“Martínez-Taboas A (1991) Multiple personality in Puerto Rico: Analysis of fifteen cases. Dissociation: Progress in the Dissociative Disorders 4: 189–192.” (Dorahy et al., 2014, p. 415)

“Lewis DO, Yeager CA, Swica Y, et al. (1997) Objective documentation of child abuse and dissociation in 12 murderers with dissociative identity disorder. American Journal of Psychiatry 154: 1703–1710.” (Dorahy et al., 2014, p. 415)

“Kluft RP (1993) Multiple personality disorder. In: Spiegel D (ed.) Dissociative Disorders: A Clinical Review. Lutherville, MD: Sidran Press, pp. 17–44.” (Dorahy et al., 2014, p. 414)

“Kluft RP (1984) Treatment of multiple personality disorder: A study of 33 cases. Psychiatric Clinics of North America 7: 9–29.” (Dorahy et al., 2014, p. 414)

“Brand BL, Classen C, McNary SW, et al. (2009c) A review of dissociative disorders treatment studies. Journal of Nervous and Mental Disease 197: 646–654” (Dorahy et al., 2014, p. 413)

“Coons PM (1994) Confirmation of childhood abuse in childhood and adolescent cases of multiple personality disorder and dissociative disorder not otherwise specified. Journal of Nervous and Mental Disease 182: 461–464.” (Dorahy et al., 2014, p. 413)

“Coons PM and Bowman ES (2001) Ten-year follow-up study of patients with dissociative identity disorder. Journal of Trauma & Dissociation 2: 73–89.” (Dorahy et al., 2014, p. 413)

“Coons PM, Bowman ES and Milstein V (1988) Multiple personality disorder: A clinical investigation of 50 cases. Journal of Nervous and Mental Disease 176: 519–527.” (Dorahy et al., 2014, p. 414)

“Dorahy MJ (2001b) Dissociative identity disorder and memory dysfunction: The current state of experimental research, and its future directions. Clinical Psychology Review 21: 771–795.” (Dorahy et al., 2014, p. 414)

“Eich E, Macauley D, Loewenstein RJ, et al. (1997) Memory, amnesia, and dissociative identity disorder. Psychological Science 8: 417–422.” (Dorahy et al., 2014, p. 414)

“Forrest KA (2001) Toward an etiology of dissociative identity disorder: A neurodevelopmental approach. Consciousness and Cognition 10: 259–293.” (Dorahy et al., 2014, p. 414)

“Ellason JW, Ross CA and Fuchs DL (1996) Lifetime Axis I and II comorbidity and childhood trauma history in dissociative identity disorder.” (Dorahy et al., 2014, p. 414)

“Şar V and Ross CA (2009) A research agenda for the dissociative disorders field. In: Dell PF and O’Neil JA (eds) Dissociation and the Dissociative Disorders: DSM-V and Beyond. New York: Routledge, pp. 693–708.” (Dorahy et al., 2014, p. 416)

“Şar V, Yargiç LI and Tutkun H (1996) Structured interview data on 35 cases of dissociative identity disorder in Turkey. American Journal of Psychiatry 153: 1329–1333.” (Dorahy et al., 2014, p. 416)

“Carlson ET. The history of multiple personality in the United States: I. The beginnings. Am J Psychiatry 1981;138:666–8.” (Brand et al., 2016, p. 266)

“Loewenstein RJ. Anna O: reformulation as a case of multiple personality disorder. In: Goodwin JM, ed. Rediscovering childhood trauma: historical casebook and clinical applications. Washington, DC: American Psychiatric Press, 1993; 139–67.” (Brand et al., 2016, p. 266)

“van der Hart O, Dorahy MJ. History of the concept of dissociation. In: Dell PF, O’Neil JA, eds. Dissociation and the dissociative disorders: DSM-V and beyond. New York: Routledge, 2009:3–26” (Brand et al., 2016, p. 266)

“Dalenberg C, Loewenstein R, Spiegel D, et al. Scientific study of the dissociative disorders. Psychother Psychosom 2007;76: 400–1” (Brand et al., 2016, p. 266)

“Sar V. The scope of dissociative disorders: an international perspective. Psychiatr Clin North Am 2006;29:227–44” (Brand et al., 2016, p. 266)

“Brand BL, Loewenstein RJ, Spiegel D. Dispelling myths about dissociative identity disorder treatment: an empirically based approach. Psychiatry 2014;77:169–89” (Brand et al., 2016, p. 267)

“Brand BL, Classen CC, McNary SW, Zaveri P. A review of dissociative disorders treatment studies. J Nerv Ment Dis 2009; 197:646–54” (Brand et al., 2016, p. 267)

“Ross CA. Epidemiology of multiple personality disorder and dissociation. Psychiatr Clin North Am 1991;14:503–17” (Brand et al., 2016, p. 267)

hunger is not an emotion, lol, it's a physical need for food. if a therapist asked you how you were feeling emotionally and you said you were hungry they would not take that answer. so there's your first problem with your understanding of emotions and self states. if you're already aware that you classify the feeling of hunger in a weird way, maybe take that into account before arguing with people about it.

for a little more explanation on self states: you don't see yourself switching into self states because as an older teen/adult your childhood self states integrate and become more stable together. ideally, you're not supposed to really *know* about them or really be able to feel them/feel yourself moving between them (i don't really like calling it "switching" as it has DID-like implications). that's why you don't remember as a child moving into these self states or why you don't really feel yourself moving in or out of self states in day to day life.

you have a much better understanding and handle on yourself than a 4 year old, and your life is not so focused on your base survival instincts of "food", "attention from caregiver", etc. so "hunger" may now be less of a self state for you and more just something that happens with your body when it runs out of food energy because you have probably developed past the need for your life to revolve around sippy cups and doc mcstuffins.

it cannot be overstated enough that while you may not feel very much when you're hungry, being hungry for a young child and not having that need met for whatever reason (for reasons of neglect or just an inappropriate time for a child to be eating or whatever), then that can be the worst thing in the world for a 2 year old because they don't know how to handle that situation, and they're upset about being unable to eat, and they can't articulate their frustration, so they scream and cry about it. meanwhile, you being hungry, you'll probably just go and make yourself food, or drink something until you're able to get food appropriately, or just wait patiently until it's time to eat your food because you have a better handle on yourself and your emotions and bodily feelings.

young children's unintegrated self states are primarily based in survival instincts, which is why hunger is/can be a self state for young children. as you grow older, you integrate these self states as you get a better handle on them and no longer need to focus all your energy on survival and learn to handle yourself and your bodily feelings and emotions better, and instead develop differing self states to assist you in the daily life of an adult, such as "work self" and "home self". these self states aren't unintegrated and chaotic like children, however, because you have grown into a well developed and multifaceted human being who has a better handle on themselves than a 5 year old with a "school self" and a "home self", (if they even have that much at that age, because differentiating properly between home and school environments at that age may be difficult for some as they may not understand it's okay to act a certain way at home but not at school yet).

another thing you're fundamentally misunderstanding is that something being an emotion or normal feeling or whatever doesn't make it *not* a self state of some kind, specifically and especially in young children. i don't understand what part of this is so hard to grasp for you, they are the same thing. it's both.

you still have self states, they're just more developed and multifaceted than that of a 4 year old.

which is honestly scarier to me than DID for some reason. maybe it's because it's going on 5 years now that i've known DID to be a part of my life. accepting schiotypy to be another huge part of my life is just adding to the basket that is my case.

but schizotypy coupled with autism... makes a lot of sense for how my brain works, which is badly. the magical thinking parts of schizotypy are really what do it for me because damn they weren't kidding, that thinking really do be fucking magical.