Believing the first 4/6 of the Dissociative Spectrum, but not the rest

Does DID/MPD exist as a clinical condition, or is DID/MPD “just an extreme example of what we all do every day.”?

Is this an “either/or” question or do these really say the same thing?

These thoughts and words come from a post that Annenco sent me – a post from someone who attempts to explore and resolve the concept of DID/MPD in 400 words or less. Hers is a kinder, gentler stereotype – tempering the concept into something everyone can more easily reject.

For those who are unfamiliar with DID/MPD, walk with us. You’ve practically accepted us already. Really.

DID/MPD is not an orphan diagnosis. DID/MPD is part of the “Dissociative Spectrum” – a continuum of dissociation starting with the most benign – “Highway hypnosis – missing your exit” through the most severe – “variations of DID/MPD.”

I think if this entire continuum were more familiar to people, uninformed beliefs and statements would be less prevalent. I believe It is simply lack of information that causes these misunderstandings – not intentional maliciousness or discrimination.

Those of us with various levels of dissociation up and through severe DID/MPD understand this, as we are familiar with (and living within) the spectrum.

We’d like others to understand it as well. Trust me that you already accept most of the continuum. Extending that to the other end isn’t hard.

Really.

The Dissociative Spectrum Revealed (at a high level)

Let me show the Dissociative Spectrum here for reference, from RealMentalHealth.com. Head over there to see a clearer version.

Let’s quickly review the six items listed on the dissociative scale, as it is the basis for my thoughts in her post.

a) Normal dissociation – the oft-quoted “highway hypnosis” example where you get lost in your thoughts and miss your exit.

b) Dissociative amnesia/fugue – blocking out painful memories. Repressing partially or totally. Sometimes ending up in difference places without realizing how you got there. Flashbacks, trancing out.

c) PTSD – more severe flashbacks, amnesia, triggers. Cycling between vivid flashbacks and memories to emotional numbing and avoidance. (Post Traumatic Stress Disorder)

d) DDNOS – Best understood as less well defined personality states than DID; amnesia may not be pervasive. Feeling like you are looking at yourself from outside your body. (Dissociative Disorder Not Otherwise Specified)

e) DID -Existence of 2 or more personality states. Caused by repeated trauma that overwhelms an individual, especially a child. To escape the trauma the child/individual may pretend it is happening to someone else. For many reasons – horrible actions, emotional and physical threats against themselves or family members.

Over time, a child begins reacting, almost like a reflex, to protect themselves…and the “pretending” and “going away” become more solidified. The amnesia of one part to the horror carried by another part solidifies the boundaries between these personality states. Then when these “states” are active, the experiences, likes, friends, and memories become associated with each. And then we have DID. (Dissociative Identity Disorder)

f) Poly-fragmented DID – DID with a much larger number of personality states, likely caused by sadistic/ritualistic abuse by multiple perpetrators over time. (RealMentalHealth)

As an aside (within an aside), it is important to note that a LARGE MAJORITY of DID (and probably ALL of poly-DID) does not happen instantaneously. The trauma(s) that launch the initial dissociation and amnesia are the seeds, but DID is most commonly caused by repeated triggers and trauma. In a majority of cases, it forms over time. Actively, but subconsciously. Because the amnesia to encapsulate the events isn’t a static event. The encapsulation must be actively maintained over time.

AND – DID and Poly-DID are the most “extreme” cases, but let’s recognize that it is PART of the continuum rather than some dangling participle with no connection to reality.

This is fundamentally what most people do not understand. Continuum, not outlier.

<!!! And remember that word “extreme” for later. There might be a quiz>.

Back to the misconceptions

The writer of the post in question (I am including no links to her blog as my discussion is related to the topic as a general misconception rather than a discussion against her post and thoughts specifically) presents several examples that fall along the Dissociation Spectrum.

These examples are escalating steps that she relays are “normal.”

a) The highway hypnosis example – missing your exit.
b) Amnesia. Partially or totally repressing memories caused by trauma or “events…that are too distressing.”
c) “[W] e switch off (dissociate) ourselves from the feelings attached to the distressing thoughts …”
d) “…[S]o we can view them almost as if it happened to somebody else.”

Hmmmm. I agree.

Implicit understanding and “sort of” acceptance of the Dissociative Spectrum

There seem to be three groups of people on this earth. On one end are those who think DID is bullshit. On the diametrically opposite end are those who either have DID or know someone who has DID.

In the middle is everyone else. People who are open-minded but not really interested enough to express an opinion either way. Those who believe it might be true perhaps after some reading or studying abnormal psych. Those who’ve read/seen the stereotypes and rejected them as too outlandish…but who feel a lingering sense of emotional believability. Who really do believe that DID is possible.

Boy, I wish this were a bell curve, but sadly it is not.

<But if we count not only those with DID, but the number of different personalities within them, we could represent a larger piece of the pie, eh? :-)>

Although this writer places herself with the non-believers, I think she is actually in the middle group. It’s just that her logic and her belief system prevent her from accepting what she might already suspect.

Compare the four “normally accepted” examples she gives above with the six milestones on the dissociative scale. She presents a 1-to-1 match from normal dissociation (a) through DDNOS (d).

Let me clarify – I am so psyched that she accepts the first 4/6ths of the scale and gives examples, but ohhh, don’t reject the last 2/6ths!

<Yes, we know how to reduce fractions. But it’s more illustrative this way.>

Maybe it’s all in the definitions. Here are her thoughts:

“Personally I do not believe in the existence of this condition as a clinical entity.” … “[M]y personal belief is that DID/MPD is just an extreme example of what we all do every day.”

An “extreme example.” I would argue that she is correct in her assessment. Looking at the spectrum, DID certainly is the extreme.

Extreme is defined as:

“Of the greatest possible degree or extent or intensity; e.g., “extreme cold.” (WordNet (r) 1.7)

Far beyond a norm in quantity or amount or degree; to an utmost degree; “an extreme example.” (WordNet (r) 1.7)

The best of worst; most urgent; greatest; highest; immoderate; excessive; most violent; as, an extreme case; (Webster’s Revised Unabridged Dictionary (1913)

She has it right. DID is the extreme. She recognizes it as the extreme.

But is it what we do every day?

…for most folks, probably not.
…for some of us, yes.

If the overwhelming trauma she lists were to be repeated over time, would that then constitute “every day”?

I really think she has the glimmer of belief but is not able to tie “extreme example of what we do every day” to DID. It’s like she just needs a little mental nudge to take that final step along the continuum she has already defined and accepted.

Another misconception about fixed and fluid personalities

The writer uses, as support for her argument, the notion that DID “presupposes that our personality is fixed and immutable, when in fact we are constantly changing and growing and evolving.”

Yes, I agree for the most part. However, this “argument” for DID is false and irrelevant.

*I* have grown and learned from my experiences, and changed over time. Some other parts of me have as well. We are not “fixed” in time, and DID does not REQUIRE a fixing in time.

However, there are some parts or personality states that are fixed in time. Having not grown or evolved. Some of those carrying the trauma, having locked it (and themselves) away in an attempt to maintain the amnesia and protect the rest. For them there has been no growth; very little connection to the outside world other than sourcing flashbacks and triggers.

Let me provide a personal example, even though I am always hesitant about sharing details.

I am a party of about 11. A few of me have grown over time. Gained experience, evolved based on successes, failures and “normal” life. I have three or four who have been/are locked in time. One has been with me, influencing me without growing much – locked in a set of behaviors related to triggers from my first trauma. One has recently rejoined me and is slowly “coming up to speed” … having been partially locked in time. One I know is a tightly knotted keeper of lashing anger wrapped around another holding most memories of another trauma. Quite a collection of growth, little growth, no growth, etc.

<A veritable cornucopia of relative evolution!>

And one particularly interesting situation, I have one special someone <careful…> who has evolved over time based on normal experiences during her time in front, but since I started all this therapy and recognized more what was happening inside me, that part has grown in a different way – understanding how her actions and words have hurt other people. She and I are helping her to recognize and temper this.

So, in this case, it is a different kind of growth – a dual growth if you will. Perhaps even more complicated than the “normal” evolving this writer asserts.

<Not just linear growth, but bifurcating growth as well!>

While this writer’s arguments are not valid, I am happy that she has given me the opportunity to consider this aspect. I hadn’t thought much on it before, but its use as an argument against DID is thought-provoking.

Breakdown in understanding

I don’t mean to hammer this writer – I am simply using her post as an example of how I think people misinterpret DID because they are not familiar with the Dissociative Spectrum. And because stereotypes are passively accepted as fact.

After what we have covered here, this becomes apparent at the end of her post:

“When we drive our car on a familiar road, we’re not consciously concentrating on every bend, line, tree or lamp post. We know the road, so we’re probably thinking about what to have for dinner, or the conversation we had with our friend on the phone last night, or any number of things. But it’s not ‘another person’ doing the driving.”

This is where it all breaks down. DID is not highway hypnosis. These two are on opposite ends of the spectrum. One cannot be used as a denial of the other.

I am sad because this convoluted logic hurts us. She seems reasonable. Perceptive enough to believe if exposed to the right information. But the lack of understanding causes her (and many many others) to draw conclusions that are simply not true. And because she seems reasonable and not rabid, it makes her conclusions all the more believable to the average person in that middle group of open-minded.

References

Turkus JA. (1992). “Spectrum of Dissociative Disorders” RealMentalHealth.com accessed on August 24, 2008 from http://www.realmentalhealth.com/dissociative_disorders/spectrum.asp

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27 Comments»

  deannandme wrote @

Emily, have you shared this explanation with the writer you are refuting? She could use this to broaden her understanding.

  emilylonelygirl wrote @

You know, I thought about it. I wasn’t sure if she would take it as a slam and I didn’t want to seem a know-it-all or disrespecting her trying to express her honest opinion. But maybe I will wander over and leave a non-threatening comment if I can’t find a private email.

Thanks for the suggestion – it is good to get another opinion that it might be welcomed.
Em

  Secret Shadows wrote @

If you don’t mind me putting a link here, my therapist told me about this article she uses when teaching about DID it’s called, “What to Do When Your Therapist Says, “I Don’t Believe in DID.”” Just thought it fit so well with what you were sharing. I have it as a link on my site.

http://www.needid.bizland.com/wrntdid.html

~Secret Shadows

  johnnamusing wrote @

Thank you Emily for this. This is definitly a post that more people need to see. I always enjoy reading your blog because you share not only your opinions and feelings but you also research and back stuff up. I think you are doing a great job in making people more aware of what DID is and isn’t. Thanks
Johnna

  annenco wrote @

ahhh! Thank you for untangling that a bit I think I have less of a headache now trying to figure out where she is sitting and trying to explain to to myself in my own head especially the growth vs fixed. Was stuck on how to explain it’s not fixed just…things get very confusing between the fact that for some parts there is little outside world experience, bad “reality testing”(PTSD/flashback) as well as some don’t “age” but they do change.
Funny, sounds like a spectrum of belief/acceptance to match the spectrum of Dissociative Experiences.

  emilylonelygirl wrote @

Hi Johnnamusing

Thanks for the kind words – it is neat when people get something out of my posts – I started this blog to share information that I had found for myself. Totally cool when others find something useful too!

Emily

  emilylonelygirl wrote @

Annenco

🙂 Wow, and “untangling” for someone with DID is a real challenge!

I totally agree with the spectrum overlap. I believe that is a BIG factor in understanding-the-acceptance.

I think I will take deannandme’s advice and give the original author a link for some first-hand insight.

  hystericalfemale wrote @

Emily, I just got your comment, (I am the person Emily is writing about here) but I am going on holiday for two weeks in about 30 minutes’ time. I look forward to discussing this further on my return.
Best,
HF

  emilylonelygirl wrote @

HF

Have a great vacation!

Emily

  davidrochester wrote @

Thank you for this phenomenally lucid explanation. I have to admit, I’m a bit guilty of trying to explain DID sometimes to folks as an extreme of something everyone does, simply to make it accessible, because it’s just so upsetting and confusing to people to try to tell them that I perceive part of my personality to be a completely different person who actually doesn’t even live in my body most of the time. And that’s actually the easiest one to explain; the other alters who are stuck in time, who don’t share my gender, who cause curious phenomena such as my not recognizing people I’ve met before … in some ways, it’s just easier to say “You know how you feel different in different situations? It’s kind of like that, except that in my case, all of those situations has its own name, and they don’t always know about each other, or realize that they’re actually living my life.”

It’s anyone’s guess as to why the hell I think that’s any easier to understand, except insofar as it relates the condition to something that everyone experiences at some time or another, whereas if I say something correct, such as “DID is a condition of personified isolated affect states,” that goes right by most folks.

Anyway. Your post here made me realize that my oversimplification is a bit of a betrayal of my own experience, inspired by some fear that people will think I’m insane. That fear is mitigated when I explain it as an extreme case of something everyone experiences to some degree.

So thanks, from all of me to all of you, for the wake-up call.

  emilylonelygirl wrote @

Hi David,

Yeah, it’s hard to explain DID to someone in the “socially acceptable” length of time one expects for a “so how ya feeling?” type of question..

I admit I never thought how to phrase it that succinctly, as I don’t share my DX beyond a very few chosen friends/family. In fact, 5 people know. One kinda knows. So, I don’t have much practice.

You said,

my oversimplification is a bit of a betrayal of my own experience, inspired by some fear that people will think I’m insane.

Whew. I believe we all think that to a degree. Is it betrayal or protection? I wouldn’t get worked up over the distinction as long as you are true to yourself internally.

Thanks for the comment
Em

  davidrochester wrote @

Well — for some reason, I’m quite open about telling people, especially new people who come into my life, and whom I intend to cultivate as real friends. So I’ve had quite a lot of practice in trying to make it understandable, and boy, it’s hard. It’s also an ongoing process. And an uphill battle. *sigh* But it also makes it a heck of a lot easier in the long run, and allows me to respect my process more … I don’t have to pretend to be normal, or pretend I’m not being triggered, or make strange excuses for sudden moods or inability to participate.

I have one friend in particular who is really good with my simply saying I’m having “one of those challenging moments” and who has learned how to calm me down simply by saying that it’s OK with him that things are hard, and asking what I need in order to feel more comfortable. I think that’s the huge benefit of telling the right people … they dispense little drops of healing.

  Tigerweave wrote @

Emily, I had never dreamed anyone would think “Everyone’s personality is fluid” as an excuse er I mean a reason for not “believing” in DID. I have had exactly the same spectrum of fluidity in my personalities. Some, particularly the ones that spent a fair bit of time fronting, are fluid and grow quite obviously. Others got stuck, or simply disappeared for stretches, as a result of the trauma, and it is delightful to watch these hurt ones start to open and grow and become fluid and dynamic in relation to the new, untraumatic environment they find themselves in. Myself as a whole being finds life easier the more fluid they become.

However, for eg, Weaver is still Weaver, with her characteristic approaches and beliefs and that unexplainable but very tangible sense of self, (vibration? pattern? colour?) that is Weaver. This is true even after 3 years of working with her, after her being stuck for 14 years.
The same is true of them all.

I have to say, too, that in non-DID people, parts of their personality can become stuck in time or behaviour as well, the amount to which varies from person to person. They are not ALL fluid all of the time. So how then can the argument have any relation to DID?

I have found this over and over again in arguments against the existence of DID – a sort of circular logic. “It can’t exist because it doesn’t exist. It doesn’t exist because it can’t exist.”
I imagine in these kind of people a DID doing a thorough switch on them, complete with changed face, voice etc, might truly freak them out to the point where they start believing.

The argument that DID is just an extreme example of what people do every day, is to me an argument *for* DID, not against. There are an awful lot of disorders that are perfectly normal, everyday traits that in some people are extreme, and in these people they are seen as a pathology.

Taking the example of a sociopath, it is the extreme of traits that we as human beings need to be able to act upon to get by. In most people these traits are only small elements of their behaviour, usually sensibly applied. In a “sociopath” it becomes something extreme, strange, and in a way a completely different believe than those same traits applied in a normal everyday way.

Still waiting to find an argument against DID that convinces all of me in this body *grins*

By the way, these days my line is “I have been diagnosed with DID. When I am treated for PTSD on its own I only gain small improvement. When treatment is the same as DID treatment, I get vast improvements. I therefore prefer therapy that treates me for DID, thankyou.”

🙂

  emilylonelygirl wrote @

Tigerweave

Boy, you always have excellent comments and insight to so many discussions. Fluidity…I have thought of it as many rivers coming together – some flow very close with currents mixing, and others are still off on tributaries. Everyone seems to have a different, but similar, analogy.

Em

  hystericalfemale wrote @

Emily, I am now back from holiday and I would like to follow through on this. I would like to do it via a post on my blog. It might take me a day or two to write as I need to get my thoughts together, but if I could link back to this post of yours it would be helpful. If you would prefer me not to link, then let me know and I will do it without actually mentioning your name or linking. Either way, feel free to comment on my post.
Best
HF

  emilylonelygirl wrote @

Hi HF

Welcome back from your vacation.

What you propose can be great -and I hope that our post interchange will be positive and an informative discussion for people to read.

I think all of us here are really interested in talking with people who are thinkers – who ponder stuff like this. You wrote a post with some genuine and good comments that many many people share. Not terrible stuff, just not quite what we experience. We’d like everyone else to get a peak at us.

So to have a post conversation between someone with DID and someone who may or may not believe in it….that can be really cool and positive for all of us.

My best
Emily

  hystericalfemale wrote @

Emily and others

My post about this is here http://hystericalfemale.wordpress.com/2008/10/26/how-does-i-become-we/

I welcome and look forward to input from anyone who is interested.

Best wishes
HF

[…] rejoin the program already in progress – the story so far: HF’s Set this house in order, my Believing the first 4/6 of the Dissociative Spectrum, but not the rest, and HF’s How does “I” become […]

[…] Believing the first 4/6 of the Dissociative Spectrum, but not the rest […]

  Shasta wrote @

Current neuroscience research holds that the brain consists of numerous subsystems which can operate in various degrees of synchrony. So therapists have no real scientific basis for believing that DID is not possible. However, what is confusing is that some alters are more differentiated than others in their emotions and function. If there is, for instance, a primitive alter, (usually young) formed to hold only a few basic emotions with no function to speak of in the environment you would not expect them to think on an abstract level and therefore to be verbally fluent. In this case it seems to me that it would be very difficult if not impossible for one like this (primarily internal) to communicate comprehensibly in writing. Verbally maybe but not in writing. They would think concretely, in images and feelings and their manner of expression would be idiosyncratic. I certainly doubt they would automatically use conventional lil-speak like “hihi.” I understand little about it though.

  emilylonelygirl wrote @

Shasta – I like the logic – therapists have no reason to say it ISN’T possible. All this focus on proving it one way or the other – how about focusing some of that time and money to healing/working with those of us who OBVIOUSLY have something going on with a lot of similar attributes?!?

I understand about the logic for very young alters – from what other people say, alter age does not exactly match chronological development age. I can’t say either way, but I can believe it is true.. Just extrapolating it to the whole forum thing is what gets me a little tweaked.

Thanks for commenting!

[…] do ya see folks? In our secret plot (which admittedly is certain to evoke the disfavor of God), multiples are infiltrating all aspects of the life process, as we are psychotic and are on a […]

  Shasta wrote @

Emily, I agree that time should be given to individuals in need rather than to theory. I know what I was saying sounded academic but really it was very personal. I look for scientific reasons to anchor my experiences, on because I have a fundamental disbelief in my emotions, my mind, and perceptions This is why I read the current research, listen to “experts” in the field and listen to accounts of people close to me. It doesnt help – not for very long which is why I never stay in therapy for long. Subjectively speaking what I go through is unlike hypnosis, and mental absorption which a lot of people say is a dissociative spectrum. When I do not take my ADD meds I can get very spacey, mesmerized and mentally absorbed so much that I am unaware of what is going on around me but this is just hyper-focusing which is a symptom of ADD. If anything could be considered at the low end of the “highway hypnosis spectrum” this would but it is not the same as dissociation. Altered identities is not just a distortion of attention. There is (in me, I mean) a sense of a unique, defined presence, a personality that is not me, anyone I ever remember meeting. “He” behaves talks, cries as any five year old would but he is not me as a five year old. He is like some a strange five year old kid I never knew before 8yrs ago. His thinking, his emotions, his intense suffering are incomprehensible to me. Still whether I can understand it or not his feelings seem to be real and human. Furthermore, even though he has learned things, his fundamental personality has remained constant over time. BTW I am still looking for a viable scientific explanation. If you have one let me know.

  emilylonelygirl wrote @

Shasta

You have gotten me interested in exploring this further – you probably know that I research things too, although this is out of my area. I have needed concrete information to anchor me out of denial. I left a therapist who was not open to discussing research, but left me floating. Was that your experience? My new therapist says she is – we shall see.

Sigh…I am learning more about myself over time – I am able now to share and feel more of the first-hand feelings of those inside me, and it is both neat and freaky at the same time. Feeling Kate next to me as we co-write humor. Feeling a small child in me who is not me, but is. Such a strange feeling like you describe.

Must be confusing to add the ADD to the mix…trying to figure out where one ends and the other begins…or the overlap between the two.

Not sure I offered this to you before, but I dug around a while back trying to understand if there was anything biological going on in the brain – you have the same interest.

What’s going on in the brain with DID? Biological markers in DID

Cami

  Shasta wrote @

I had a therpist say that to me while back. She said she would wait and that until then she would remain skeptical. I soon found out that she had several preconceived biases. One was that she thought it was just a fad. The other is that she stuck rigidly to the DSM-IV and its description of what is more polyfragmented DID. This only showed me that she lacked experience and breadth of knowledge. Once I wsa fortunate to meet and have some extended discussions with Colin Ross and he was very willing to accept “lower spectrum forms of DID. When I told him all about one case he said that a lower impact trauma, if it was pervasive and continued long enough would end up producing the experiences I described. I did not tell him I was talking about myself. I do not think people should have many preconceptions for or against. Ts might really need to “wait and see” but they have to be humble enough to admit the mysterious nature of the mind and the wide variations of human experience. When I talked to that “wait and see” therapist I thanked her for the clean bill of health and I left happy that I would not have to deal with it anymore. I got about as far as my car before that assurance broke down. If anyone has searched for reasons to explain it all away I have. If anything I was more skeptical that she ever was and I had many years of waiting to see if it would go away. About the time I think I have escaped something happens and I am back in the same place again. I have tried to think of them as complexes and to admit that their pain was mine but knowing that, saying that did no good. The child got angry and said that no, those were his feelings and not mine. Like I told therapists before. You want to talk cognitively then I can talk all day but only he can tell you about the emotions. That is dissociational talk in itself. As to the other, the consensus of modern neuroscience is that the brain is an aggregate of many subsystems. The fact that the therapists dont get this shows a fundamental flaw in their training. They still accept the illusion because they do not understand how complicated it really is. The see the face of the clock and do not remember that it is merely the result of the operation of many gears, wheels some small, some big which work together to produce that face. The difference is that these “wheels” are not mechanisms but living things. The wonderful thing is that when trauma happens (some) peoples brains have the capacity to survive and still function by distributing the effects throughout the whole system. If we were only ONE the impact would be felt in every part and it could be destroyed. In a way we, take up the parts of and say “live” and they assume an existence of their own. Now that is a miracle

  emilylonelygirl wrote @

About the time I think I have escaped something happens and I am back in the same place again.

Yeah. Me too. Looking back through diaries, I see that about every 7-10 years, something smacks me and I regain this awareness that something is not right in me. Then I push it away. Finally now, I realize that there are periods of stress where I was unable to maintain the dissociation to see what was really happening in me. And then my diaries were tortured explorations of why I felt like two people. And in those times I dig through research. Like you it seems.

Yes, it would be great if therapists were required to get some sort of physiology training to at least acknowledge that there is something more going on.

[…] as Multiple Personality Disorder or MPD. Just before going on holiday I received a comment from emilylonelygirl who had written a post of her own referring to mine (without identifying me) She told me that she […]


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