Structural Dissociation of the Personality

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Structural DissociationStructural dissociation (SD) is one of the three accepted models for the etiology of dissociative identity disorder. <ref name=HauntedSelf/> <ref name=Dell2009/>{{Rp|158-165}} {{See also| Structural dissociation}} of the PersonalityEvery individual has a personality that is composed of many diverse, fragmentary and generally illusory images of [[Personality|self]]. (see multiples) <ref name=Noricks2011/>The DSM-IV uses the term identity in its definition of dissociation. (see identity) <ref name=Dell2009/>{{Rp|127}}[edit]

Structural dissociationStructural dissociation of the personality is a theory that describes the effect of trauma on the personality. It applies to PTSD, complex PTSD, other specified dissociative disorder and dissociative identity disorder. {{See also| Structural dissociation}} of the personality is the current and most-accepted theory of dissociation. It describes the different parts of a personality which form as a result of trauma which cannot be processed (preventing it from being integrated). As a result of the unprocessed traumaThe most fundamental effect of trauma is dissociation, so we define trauma as the event(s) that cause dissociation. <ref name=Howell2011/>{{Rp|75}} The original trauma in those with dissociative identity disorder was failure of secure attachment with a primary attachment figure in early childhood. <ref name=Howell2011/>{{Rp|83}}, the personality becomes divided into an emotional partAn alter (or identity fragment) whose main job is to hold unintegrated trauma memory. A term used in structural dissociation. <ref name=HauntedSelf/>{{Rp|38-39}} which remains fixated in the traumatic experiences, which it often reenacts, and an apparently normal part which conducts the "daily business of life", and avoids both the feelings and information related to traumaThe most fundamental effect of trauma is dissociation, so we define trauma as the event(s) that cause dissociation. <ref name=Howell2011/>{{Rp|75}} The original trauma in those with dissociative identity disorder was failure of secure attachment with a primary attachment figure in early childhood. <ref name=Howell2011/>{{Rp|83}}.[1]:68Integration is at the coreThe terms "core" and "original" were used back in history to mean the part that body was born with, but today we know there is no such part. Many also incorrectly assume the host or ANP is what they call the core. <ref name=Howell2011/>{{Rp|59}} <ref name=HauntedSelf/>{{Rp|80, 87-88}} (see personality and alters) (see personality)Note: Outside of the dissociative disorders the term core is used by some to mean an individuals "suchness;" a part that is "beneath narrative and memory, emotional reactivity and habit." <ref name=Siegel2011/>{{Rp|208-209}} of the theory of structural dissociationStructural dissociation (SD) is one of the three accepted models for the etiology of dissociative identity disorder. <ref name=HauntedSelf/> <ref name=Dell2009/>{{Rp|158-165}} {{See also| Structural dissociation}}Structural dissociation of the personality is a theory that describes the effect of trauma on the personality. It applies to PTSD, complex PTSD, other specified dissociative disorder and dissociative identity disorder. {{See also| Structural dissociation}}. Pierre Janet "characterized mental health in terms of the capacity for differentiation and integration" [2]:2. In other words, the ability to see the 'big picture' and the ability to not over-generalize things. Dissociation happens when experiences get too overwhelming they cannot be integrated directly. It may take a while (the more overwhelming or traumatizing the experience, the more difficult it is to integrate and it may never succeed.

EPAn alter (or identity fragment) whose main job is to hold unintegrated trauma memory. A term used in structural dissociation. <ref name=HauntedSelf/>{{Rp|38-39}} and ANPAn alter who often acts as the host, does not hold trauma memories (has amnesia for trauma). Dissociative identity disorder is the only mental disorder where an individual can have two or more ANP. <ref name=HauntedSelf/> A term used for the part that often acts as the host alter in individuals with dissociative identity disorder according to the model of structural dissociation. {{See also| structural dissociation}} - origins[edit]

An EPAn alter (or identity fragment) whose main job is to hold unintegrated trauma memory. A term used in structural dissociation. <ref name=HauntedSelf/>{{Rp|38-39}} ("emotional" part) is the part that takes the trauma. Sometimes, it is still 'stuck' in traumaThe most fundamental effect of trauma is dissociation, so we define trauma as the event(s) that cause dissociation. <ref name=Howell2011/>{{Rp|75}} The original trauma in those with dissociative identity disorder was failure of secure attachment with a primary attachment figure in early childhood. <ref name=Howell2011/>{{Rp|83}}, but it may also be able to function in daily life (in the case of DID). It does not remember the trauma like a story, like a personal history, but rather like it happened at exact that moment (flashbackA flashback is a reactivated traumatic memory experienced as intrusive thoughts, feelings, or images associated with past trauma, but lacking a sense of being from the past. <ref name=Siegel2012/>{{Rp|30}} {{See also | Grounding techniques}}). When such a memory"Memory is not a static thing, but an active set of processes." <ref name=Siegel/>{{Rp|51}} "Our earliest experiences shape not only what we remember, but also how we remember and how we shape the narrative of our lives. Memory can be seen as the way the mind encodes elements of experience into various forms of representation. As a child develops, the mind begins to create a sense of continuity across time, linking past experiences with present perceptions and anticipations of the future." <ref name=Siegel/>{{Rp|11}} comes back, the whole event is re-experienced like before. Memories can still have some small inconsistencies.[2]:5-6. See also amnesia.

An ANPAn alter who often acts as the host, does not hold trauma memories (has amnesia for trauma). Dissociative identity disorder is the only mental disorder where an individual can have two or more ANP. <ref name=HauntedSelf/> A term used for the part that often acts as the host alter in individuals with dissociative identity disorder according to the model of structural dissociation. {{See also| structural dissociation}} ("apparently normal" part) is (usually) not (much) aware of the trauma or is detached from the trauma (feels no connection to it).

The ANPAn alter who often acts as the host, does not hold trauma memories (has amnesia for trauma). Dissociative identity disorder is the only mental disorder where an individual can have two or more ANP. <ref name=HauntedSelf/> A term used for the part that often acts as the host alter in individuals with dissociative identity disorder according to the model of structural dissociation. {{See also| structural dissociation}} is not always that "apparently normal". Some are indeed as if there's nothing wrong. The consequences of the trauma (like amnesia and lower level of functioning) are well hidden or not that strong/obvious. But others may have far more problems with amnesia and continuing intrusions by the EPAn alter (or identity fragment) whose main job is to hold unintegrated trauma memory. A term used in structural dissociation. <ref name=HauntedSelf/>{{Rp|38-39}}(s). [2]:2-3,6-7.

Primary structural dissociationAcute stress disorder and Posttraumatic stress disorder are examples. An individual with primary structural dissociation will have one ANP and one EP. <ref name=HauntedSelf/>{{Rp|5-7}} {{See also| Structural dissociation}} - Acute Stress Disorder and simple Posttraumatic Stress Disorder[edit]

In simple PTSD, the EPAn alter (or identity fragment) whose main job is to hold unintegrated trauma memory. A term used in structural dissociation. <ref name=HauntedSelf/>{{Rp|38-39}} is originally the collection of memories that could not be integrated into the coreThe terms "core" and "original" were used back in history to mean the part that body was born with, but today we know there is no such part. Many also incorrectly assume the host or ANP is what they call the core. <ref name=Howell2011/>{{Rp|59}} <ref name=HauntedSelf/>{{Rp|80, 87-88}} (see personality and alters) (see personality)Note: Outside of the dissociative disorders the term core is used by some to mean an individuals "suchness;" a part that is "beneath narrative and memory, emotional reactivity and habit." <ref name=Siegel2011/>{{Rp|208-209}} person. A part of the personality has been dissociated. The memories were too heavy to integrate. This EPAn alter (or identity fragment) whose main job is to hold unintegrated trauma memory. A term used in structural dissociation. <ref name=HauntedSelf/>{{Rp|38-39}} may get a rudimentary sense of self. [2]:2-3,5 In complex PTSD the EPAn alter (or identity fragment) whose main job is to hold unintegrated trauma memory. A term used in structural dissociation. <ref name=HauntedSelf/>{{Rp|38-39}} is divided further[3]. This was first described by Myers (1940) in his studies of acutely traumatized World War I combat soldiers.[3]

Secondary structural dissociationDDNES and borderline personality disorder are examples. <ref name=HauntedSelf/> An individual with secondary structural dissociation will usually have one ANP and more than one EP. <ref name=HauntedSelf/>{{Rp|5-7}} {{See also| structural dissociation}} - complex PTSD, Disorders of Extreme Stress and OSDD[edit]

There remains a single ANPAn alter who often acts as the host, does not hold trauma memories (has amnesia for trauma). Dissociative identity disorder is the only mental disorder where an individual can have two or more ANP. <ref name=HauntedSelf/> A term used for the part that often acts as the host alter in individuals with dissociative identity disorder according to the model of structural dissociation. {{See also| structural dissociation}}, but there are several Emotional Parts Complex PTSD (also known as Disorder of Extreme Stress, DESNOS) and Other Specified Dissociative Disorder (formerly known as DDNOS).[3] This is also the case in trauma-related borderline personality disorder. The EPs can include freeze responses such as analgesia (inability to feel pain) and anesthesialoss of sensory awareness; all sensory modalities, touch, kinesthesia, smell, taste, hearing, vision. <ref name=Dell2009/>{{Rp|261-262}} A negative symptom of somatoform dissociation (loss of a physical ability) (numbness/loss of feeling).[3]

Tertiary structural dissociationThis is present in dissociative identity disorder, and is defined as an individual usually having more than one ANP and more than one EP. <ref name=HauntedSelf/>{{Rp|5-7}} <ref name=Hart1996/> - DIDDissociative identity disorder is a disorder of mental states, where a individual has amnesia due to switching between different personality states (also known as alters). <ref name=Dell2009/>{{Rp|319-321}} {{See also| Dissociative Identity Disorder}}[edit]

In Dissociative Identity Disorder, there is no 'coreThe terms "core" and "original" were used back in history to mean the part that body was born with, but today we know there is no such part. Many also incorrectly assume the host or ANP is what they call the core. <ref name=Howell2011/>{{Rp|59}} <ref name=HauntedSelf/>{{Rp|80, 87-88}} (see personality and alters) (see personality)Note: Outside of the dissociative disorders the term core is used by some to mean an individuals "suchness;" a part that is "beneath narrative and memory, emotional reactivity and habit." <ref name=Siegel2011/>{{Rp|208-209}}', or unified sense of self, to begin with. [4] In childhood, there was no single, unified personality. Children start out basically separated. They do not have an integrated personality yet. Up until roughly the age of seven, children integrate the different personality states they have until they have one, unified personality. Before that, they can forget from one moment to the next what they were doing. Early insecure attachmentThe communication of emotion between an infant and their primary caregiver(s) is essential to shaping the developing mind. "Emotion serves as a central organizing process within the brain. In this way, an individual's abilities to organize emotions - a product in part, of early attachment relationships directly shapes the ability of the mind to integrate experience and to adapt to future stressors." <ref name=Siegel/>{{Rp|9}} Interruption in the attachment pattern of young children with their caretaker(s) has been shown to be a primary precursor to Dissociative Disorder pathology. (see etiology) <ref name=Medscape/> <ref name=HauntedSelf/>{{Rp|85}} <ref name=Howell2011/>{{Rp|97}} to the primary caregiver, particularly disorganized attachmentThe communication of emotion between an infant and their primary caregiver(s) is essential to shaping the developing mind. "Emotion serves as a central organizing process within the brain. In this way, an individual's abilities to organize emotions - a product in part, of early attachment relationships directly shapes the ability of the mind to integrate experience and to adapt to future stressors." <ref name=Siegel/>{{Rp|9}} Interruption in the attachment pattern of young children with their caretaker(s) has been shown to be a primary precursor to Dissociative Disorder pathology. (see etiology) <ref name=Medscape/> <ref name=HauntedSelf/>{{Rp|85}} <ref name=Howell2011/>{{Rp|97}}, increases the likelihood of a child having dissociative reactions to later traumaThe most fundamental effect of trauma is dissociation, so we define trauma as the event(s) that cause dissociation. <ref name=Howell2011/>{{Rp|75}} The original trauma in those with dissociative identity disorder was failure of secure attachment with a primary attachment figure in early childhood. <ref name=Howell2011/>{{Rp|83}}, creating a pathway to trauma-related disorders including DIDDissociative identity disorder is a disorder of mental states, where a individual has amnesia due to switching between different personality states (also known as alters). <ref name=Dell2009/>{{Rp|319-321}} {{See also| Dissociative Identity Disorder}}.[5]:17

When trauma occurs, this integration may fail if the child does not have a secure attachment - most commonly this is due to neglect or abuse.[5]:17 The different parts then develop separately and each can later form into a separate sense of self (in varying degrees of complexity). The distinction between EPAn alter (or identity fragment) whose main job is to hold unintegrated trauma memory. A term used in structural dissociation. <ref name=HauntedSelf/>{{Rp|38-39}} and ANPAn alter who often acts as the host, does not hold trauma memories (has amnesia for trauma). Dissociative identity disorder is the only mental disorder where an individual can have two or more ANP. <ref name=HauntedSelf/> A term used for the part that often acts as the host alter in individuals with dissociative identity disorder according to the model of structural dissociation. {{See also| structural dissociation}} is now more blurred, because there was no part that was split1. In dissociative identity disorder - the part of the personality that will take abuse already exist in a child inner world (see inner world). What occurs is an ongoing separation of parts, rather than a "split or fracture" of one part from another. <ref name=Howell2011/>{{Rp|87-88}} The term "splitting or fractured" used when describing dissociative identity disorder is a misnomer. For example: a child on the ceiling watching a disturbing event, has not "split off" from the part of the personality that is enduring that trauma event, however the individual might develop Acute Stress Disorder (ASD) or posttraumatic stress disorder (PTSD). In dissociative identity disorder a long history of chronic abuse is almost always present, as well as the child typically having a disorganized attachment with their caregiver(s). <ref name=Dell2009/>{{Rp|302-306}} <br /> {{See also| Splitting}}2. Not in DID - Viewing oneself or others as being all good or all bad, common in borderline personality disorder. A psychological defense mechanism.<ref name=Seligman2004/>{{Rp|121}} {{See also| Borderline personality disorder}} off (as EPAn alter (or identity fragment) whose main job is to hold unintegrated trauma memory. A term used in structural dissociation. <ref name=HauntedSelf/>{{Rp|38-39}}) to begin with, and all can have different levels of traumatization. (citation needed)

But what is such a part, exactly? Difficult to explain (read the references for a complete explanation), but basically, it are what are called "action systems". Psychobiological systems that execute various tasks in daily life. For example, systems "that control control attachmentThe communication of emotion between an infant and their primary caregiver(s) is essential to shaping the developing mind. "Emotion serves as a central organizing process within the brain. In this way, an individual's abilities to organize emotions - a product in part, of early attachment relationships directly shapes the ability of the mind to integrate experience and to adapt to future stressors." <ref name=Siegel/>{{Rp|9}} Interruption in the attachment pattern of young children with their caretaker(s) has been shown to be a primary precursor to Dissociative Disorder pathology. (see etiology) <ref name=Medscape/> <ref name=HauntedSelf/>{{Rp|85}} <ref name=Howell2011/>{{Rp|97}} of offspring to parents, parental attachmentThe communication of emotion between an infant and their primary caregiver(s) is essential to shaping the developing mind. "Emotion serves as a central organizing process within the brain. In this way, an individual's abilities to organize emotions - a product in part, of early attachment relationships directly shapes the ability of the mind to integrate experience and to adapt to future stressors." <ref name=Siegel/>{{Rp|9}} Interruption in the attachment pattern of young children with their caretaker(s) has been shown to be a primary precursor to Dissociative Disorder pathology. (see etiology) <ref name=Medscape/> <ref name=HauntedSelf/>{{Rp|85}} <ref name=Howell2011/>{{Rp|97}} to and care for offspring, exploration, and play". In simple PTSD, an action system of fear can be split1. In dissociative identity disorder - the part of the personality that will take abuse already exist in a child inner world (see inner world). What occurs is an ongoing separation of parts, rather than a "split or fracture" of one part from another. <ref name=Howell2011/>{{Rp|87-88}} The term "splitting or fractured" used when describing dissociative identity disorder is a misnomer. For example: a child on the ceiling watching a disturbing event, has not "split off" from the part of the personality that is enduring that trauma event, however the individual might develop Acute Stress Disorder (ASD) or posttraumatic stress disorder (PTSD). In dissociative identity disorder a long history of chronic abuse is almost always present, as well as the child typically having a disorganized attachment with their caregiver(s). <ref name=Dell2009/>{{Rp|302-306}} <br /> {{See also| Splitting}}2. Not in DID - Viewing oneself or others as being all good or all bad, common in borderline personality disorder. A psychological defense mechanism.<ref name=Seligman2004/>{{Rp|121}} {{See also| Borderline personality disorder}} off. In Dissociative Identity Disorder, there can remain a divide between these action systems. (See also: ego states). [2]:7-10

References[edit]

  1. ^ Howell, Elizabeth F. (2012). The Treatment of Dissociative Identity Disorder. ISBN 1135845832.
  2. ^ a b c d e Nijenhuis, Ellert R.S.. Trauma-related structural dissociation of the personality. retrieved on 28 January 2014
  3. ^ a b c d Nijenhuis, E.R.S., Van der Hart, O. & Steele, K.. David Baldwin's Trauma Information Pages: Trauma-related structural dissociation of the personality. Trauma Information Pages. retrieved on 29 January 2014
  4. ^ Middleton, Warwick. Owning the past, claiming the present: perspectives on the treatment of dissociative patients.. Australasian Psychiatry, volume 13, issue 1, page 40-49. (doi:10.1111/j.1440-1665.2004.02148.x)
  5. ^ a b Liotti, Giovanni. Trauma, Dissociation, and DisorganizedAttachment: Three Strands of a Single Braid. Psychotherapy: Theory, research, practice, training, volume 41, issue 4, page 472-486. (doi:10.1037/0033-3204.41.4.472)