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Vignette: midbrain and "distinct state" creation
It's Annabelle's 6th birthday and she has spent the last 5-years of her life in a literal struggle to survive; even though she appears normal to casual observers, her appearance does not relate the truth. Annabelle is dying mentally and she must do something drastic if she is going to survive. Her midbrain has been remiss, but suddenly its on "full alert." If this important part of her brain does not eliminate her "stress," she will mentally give up and most likely die. Her dissociative identity disorder takes an overwhelming amount of energy and she does not have much left to function with. In response, her brain interacts with her mind to create a new distinct state which does take the pressure off of Annabelle's nervous system. As a result, however, Annabelle will now loose access to the memories that tell her who she is. Annabelle's painful memories must be separate from the distinct state that acts as Annabelle most often. Annabelle's mind and brain will create as many distinct states as she needs to survive.

Vignette: creating a distinct and less than distinct state
Annabelle just turned 6-years old a month or so ago, and she already has two distinct states, and 8 less than distinct states. Today she is in a horrible car accident that instantly killed the driver, and she is left alone in the car with injuries. Her head is bleeding, her right ankle is crushed, and her left arm is pinned between two objects and she can't pull it free. This is trauma. She already has dissociative identity disorder, and she knows how to create distinct states, but of course it's not something she does knowingly. She calms and her mind goes to thoughts that are not related to the situation she is in, and she is mentally drifting away. If she were too mentally weak then she could die, but Annabelle's mind is far from weak. Her mind has had to work harder than any mind should just so she can thrive, and her busy mind is certainly not at rest during trauma. Adrenaline is flowing through her tiny body, and her brain is highly active. Time is passing while Annabelle is alone with her thoughts, but she does not feel any pain because her mind is actively engrossed in the ''Freeze-Flight-Fight-Fright-Faint.' She is lost in one of them. Let's say it's the fight response. That 6-year old little girl is a fighter and she is not giving up. Remember the vignette where her midbrain came to action? It's again busy and it's creating a brand spanking new distinct state that, when this little girl is safe, will take over and it will have no idea of anything that happened in the accident.

You might wonder how creating a distinct state is different from trauma creating a less than distinct state in response to the accident, and it's highly likely that she did create unprocessed memories, which when they become overwhelming will create a new less than distinct state, which that state will most likely remember every detail of the accident and in horrifying detail. Let's go back to the accident and take a better look at what Annabelle is doing. She was in the backseat and was looking out the side window when she saw a truck headed for the car she was in and crash into the side of it. At that moment the brain signaled the mind that it's in distress and if Annabelle survives the impact she is going to need to respond. She is trapped and can't move around the car too much, but she can see the driver is non-responsive, her ankle is damaged, and there is a cut over her left eye, and she knows she can't get her left arm free. She has not froze, she can't run away she is trapped, she is afraid, but not so afraid she can't function, and she has not fainted. Annabelle is fighting, and so is actively participating in her own rescue, and she has eight less than distinct states that were immediately signaled by the brain and the most prepared for this problem will take over. Since he is the one at the accident, then he is the one that is going to hold the memory of that trauma. If and when he becomes overwhelmed by either that trauma, or another one down the road, then another less than distinct state will be created, but the trauma memory stays with the state that had the experience.

Vignette: switching between distinct and less than distinct states
Annabelle, a 25 year old woman gets in her car and drives to her appointment with Dr. Getsitright, a mental health professional. She (distinct state-1) knocks on his office door and when it opens she becomes slightly disoriented, but quickly pulls herself together in an almost seamless manner. (Distinct state-2) walks into the office, introduces herself and a large bookcase catches her attention. The shelves are filled with a variety of books, journals, nick-knacks and a few wood and metal antique toys near the bottom. Dr. Getsitright invites Annabelle to have a seat, but then her eyes are drawn to the bottom of the bookcase where she sees a "happy meal" bag and she switches to a less than distinct, child-like state. She kneels down on the floor in front of the bag and inhales, but the familiar odor she was looking for is not there and so she looses interest. Then she is startled as she suddenly hears a noise and notices that someone is in the room with her. This causes the child-like less than distinct state to switch to (distinct state-3), who quickly tries to make sense of where she is at. This is a new place to her, but she can't accept that and tries to make sense of her surroundings. No other disorder will have a personality state that constantly does this. (Distinct state-3) is unable to acknowledge that she does not know what is going on and so she repeats her familiar pattern, which is to attempt to fit into the situation. Dr. Getsitright is observant and has noticed the switching, but he wants to see if he can get (distinct state-3) to switch directly to another distinct state. He asks, have you decided which movie you and I are going to go and watch? (Distinct state-3) looks at Dr. Getsitright and replies. You choose. Dr. Getsitright then says, look at the time. We have gone far past our session time. That causes (distinct state-3) to switch to (distinct state-2,) who was the one that first walked into the office. She glances at the clock on the wall and says, Dr. Getsitright, I have only been here a few minutes. You must be mistaken. Then Dr. Getsitright replies, Annabelle, don't you remember that I told you my clock is broken? Had it started to rain yet when you arrived here today? (Distinct state-2) switches to (distinct state-1) who says, no, there was not a cloud in the sky. Then she glances at the clock and mentions how quickly the time has passed during her session and how she wishes they had more time.

Notice that distinct states can fail to share memory with both distinct states and less than distinct states, but the distinct states will usually disregard the fact that they often have no idea how they get from one place to another or what might have happened in "their life" before they step into it. This is not purposeful disregard, but is a function of amnesia and dissociation. It's due to the chemical, neurological and physical makeup of the distinct states and the dissociative boundaries associated with them. Distinct states in dissociative identity disorder are highly phobic of the other states in the personality system and they cannot acknowledge them until they have had a great deal of work to aid them in that direction.

Etiological vignette
Anabelle is a few days old and has already been suffocated, starved and has not felt love and comfort from any caretaker. She is vulnerable to all sorts of mental disorders because of this neglect. Through the early months of her life she lies in her crib alone with her thoughts, and is not comforted, held, or played with. She is hungry, her diaper is rarely changed and she has no one who will respond to her basic needs. An infant in this situation becomes lethargic and fails to thrive and dies, or copes through dissociation. Annabelle is learning a "basic animal response" and no longer responds to the constant pain she has, such as hunger or diaper rash. Annabelle survives, and is very busy at the job of survival. She is learning to comfort and sooth herself since she only has herself to turn to. At 12-months old she displays the behavior observed in a child with disorganized attachment. She is confused, and desperately needs a caregiver, but hers are not safe, which is evident in her behavior when she interacts with them. Her brain needs nourishment and stimulation and she has not had enough of either. Her mind is actively stimulating her brain, and in fact, it's doing it in excess to make up for the lack of external stimulation. She is creating the base that is needed to have a complex Dissociative Disorder. There are only two complex Dissociative Disorders and just one requires that Annabelle's first year of life involves unprocessed trauma. The other complex Dissociative Disorder, other specified dissociative disorder does not have this requirement.