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Ego State Disorder - just stumbled upon this and it so very much resonates

Catch_22

Well-Known Member
#41
My reading stamina is crap, but with enough interest I can push through. One of those links i posted yesterday has interesting things to say about presentations, prevalence, diagnosis and development of DID. (This one I can copy and paste, yay)

So just skimming the early parts of "Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision" some info springs out. I summarised each section in "Dante Version" in-case it gets too dry. I also coloured Original Text in Orange, and Dante Version in Green.

Do tell me if I make any incorrect assumptions or interpretations, if this is all just kinda patronisingly "spoon-fed". or if my "Dante's Version" is just not necessary... (You said you had trouble researching so I tried, also summarising for others is the best way to organise and distil new understanding)

Diagnostic Criteria for DID
The DSM–IV–TR (American Psychiatric Association, 2000a) lists the following diagnostic criteria for DID (300.14; p. 529):
A. The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self).
B. At least two of these identities or personality states recurrently take control of the person’s behaviour.
C. Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.
D. The disturbance is not due to the direct physiological effects of a substance (e.g., blackouts or chaotic behavior during Alcohol Intoxication) or a general medical condition (e.g., complex partial seizures). Note: In children, the symptoms are not attributable to imaginary playmates or other fantasy play


Dante Version: @extraterrestrialone I think you have DID, you have 2 separately functioning identities, no single identity has executive control 100% of the time, you have gaps in memory and none of this is due to drugs or other underlying conditions like complex partial seizures.

Excerpt from EPIDEMIOLOGY, CLINICAL DIAGNOSIS, AND DIAGNOSTIC PROCEDURES
...The difficulties in diagnosing DID result primarily from lack of education among clinicians about dissociation, dissociative disorders, and the effects of psychological trauma, as well as from clinician bias. This leads to limited clinical suspicion about dissociative disorders and misconceptions about their clinical presentation. Most clinicians have been taught (or assume) that DID is a rare disorder with a florid, dramatic presentation. Although DID is a relatively common disorder, R. P. Kluft (2009) observed that “only 6% make their DID obvious on an ongoing basis” (p. 600). R. P. Kluft (1991) has referred to these moments of visibility as “windows of diagnosability” (also discussed by Loewenstein, 1991a). Instead of showing visibly distinct alternate identities, the typical DID patient presents a polysymptomatic mixture of dissociative and posttraumatic stress disorder (PTSD) symptoms that are embedded in a matrix of ostensibly nontrauma-related symptoms (e.g., depression, panic attacks, substance abuse, somatoform symptoms, eating-disordered symptoms). The prominence of these latter, highly familiar symptoms often leads clinicians to diagnose only these comorbid conditions. When this happens, the undiagnosed DID patient may undergo a long and frequently unsuccessful treatment for these other conditions.


Dante Version: "Clinicians" arent trained well enough, and dont look hard enough to ever actually diagnose DID except in rare cases because DID is seen as far more rare than it is, most people with DID only show diagnosable symptoms for a fraction of time, for the rest of the time they seem normal and show generalised dissociative tendencies and a host of common disorders like depression, panic attacks, substance abuse, eating disorder and physical symptoms like headaches or chest pains, and so on and so forth, and since clinicians arent looking for DID and wouldnt know what to look for if they were, people with DID usually end up diagnosed and treated for the "comorbid" conditions (conditions that happen at the same time) treatments which ultimately fail because they are not being treated for the underlying cause (DID), only the symptoms (Depression, anxiety etc).

Dell and O’Neil’s (2009) definition of Dissociation:
The essential manifestation of pathological dissociation is a partial or complete disruption of the normal integration of a person’s psychological functioning. . . . Specifically, dissociation can unexpectedly disrupt, alter, or intrude upon a person’s consciousness and experience of body, world, self, mind, agency, intentionality, thinking, believing, knowing, recognizing, remembering, feeling, wanting, speaking, acting, seeing, hearing, smelling, tasting, touching, and so on. . . . [T]hese disruptions . . . are typically experienced by the person as startling, autonomous intrusions into his or her usual ways of responding or functioning. The most common dissociative intrusions include hearing voices, depersonalization, derealization, “made” thoughts, “made” urges, “made” desires, “made” emotions, and “made” actions. (p. xxi)

Dante Version: I think he said it quite well, so TLDR version instead: The mind's reasoning, perception, bodily experience, will, belief structures etc should all connect fluidly together, Dissociation is where a part of the mind is functionally separated from the rest and this separation usually feels like an entirely foreign entity interfering with the mind as a whole. This can be seen as thoughts, urges, desires, emotions, or actions which are forced upon the mind of the sufferer from outside rather than being part of their mental process, or an addition or derealisation of the sufferer's perception of their surroundings (hearing voices, things not seeming real etc)

Theories on the Development of DID
It is outside the scope of these Guidelines to provide a comprehensive discussion of current theories concerning the development of alternate identities in DID (see Loewenstein & Putnam, 2004, and Putnam, 1997, for a more complete discussion). Briefly, many experts propose a developmental model and hypothesize that alternate identities result from the inability of many traumatized children to develop a unified sense of self that is maintained across various behavioral states, particularly if the traumatic exposure first occurs before the age of 5. These difficulties often occur in the context of relational or attachment disruption that may precede and set the stage for abuse and the development of dissociative coping (Barach, 1991; Liotti, 1992, 1999). Freyd’s theory of betrayal trauma posits that disturbed caregiver–child attachments and parenting further disrupt the child’s ability to integrate experiences (Freyd, 1996; Freyd, DePrince, & Zurbriggen, 2001). Fragmentation and encapsulation of traumatic experiences may serve to protect relationships with important (though inadequate or abusive) caregivers and allow for more normal maturation in other developmental areas, such as intellectual, interpersonal, and artistic endeavors. In this way, early life dissociation may serve as a type of developmental resiliency factor despite the severe psychiatric disturbances that characterize DID patients (Brand, Armstrong, Loewenstein, & McNary, 2009).

Severe and prolonged traumatic experiences can lead to the development of discrete, personified behavioral states (i.e., rudimentary alternate identities) in the child, which has the effect of encapsulating intolerable traumatic memories, affects, sensations, beliefs, or behaviors and mitigating their effects on the child’s overall development. Secondary structuring of these discrete behavioral states occurs over time through a variety of developmental and symbolic mechanisms, resulting in the characteristics of the specific alternate identities. The identities may develop in number, complexity, and sense of separateness as the child proceeds through latency, adolescence, and adulthood (R. P. Kluft, 1984; Putnam, 1997). DID develops during the course of childhood, and clinicians have rarely encountered cases of DID that derive from adult-onset trauma (unless it is superimposed on preexisting childhood trauma and preexisting latent or dormant fragmentation).

Another etiological model posits that the development of DID requires the presence of four factors: (a) the capacity for dissociation; (b) experiences that overwhelm the child’s nondissociative coping capacity; (c) secondary structuring of DID alternate identities with individualized characteristics such as names, ages, genders; and (d) a lack of soothing and restorative experiences, which renders the child isolated or abandoned and needing to find his or her own ways of moderating distress (R. P. Kluft, 1984). The secondary structuring of the alternate identities may differ widely from patient to patient. Factors that may foster the development of highly elaborate systems of identities are multiple traumas, multiple perpetrators, significant narcissistic investment in the nature and attributes of the alternate identities, high levels of creativity and intelligence, and extreme withdrawal into fantasy, among others. Accordingly, therapists who are experienced in the treatment of DID typically pay relatively limited attention to the overt style and presentation of the different alternate identities. Instead, they focus on the cognitive, affective, and psychodynamic characteristics embodied by each identity while simultaneously attending to identities collectively as a system of representation, symbolization, and meaning.

The theory of “structural dissociation of the personality,” another etiological model, is based on the ideas of Janet and attempts to create a unified theory of dissociation that includes DID (Van der Hart et al., 2006). This theory suggests that dissociation results from a basic failure to integrate systems of ideas and functions of the personality. Following exposure to potentially traumatizing events, the personality as a whole system can become divided into an “apparently normal part of the personality” dedicated to daily functioning and an “emotional part of the personality” dedicated to defense. Defense in this context is related to psychobiological functions of survival in response to life threat, such as fight/flight, not to the psychodynamic notion of defense. It is hypothesized that chronic traumatization and/or neglect can lead to secondary structural dissociation and the emergence of additional emotional parts of the personality.

In short, these developmental models posit that DID does not arise from a previously mature, unified mind or “core personality” that becomes shattered or fractured. Rather, DID results from a failure of normal developmental integration caused by overwhelming experiences and disturbed caregiver–child interactions (including neglect and the failure to respond) during critical early developmental periods. This, in turn, leads some traumatized children to develop relatively discrete, personified behavioral states that ultimately evolve into the DID alternate identities.

Dante Version: Opinions vary on the exact mechanic behind the development of DID, three main theories are summarised below (though if you are not feeling it, you can skip to the "Summary".

Theory 1: An abusive relationship with a caregiver will cause the mind to see the caregiver as both a serious and destructive danger, and someone they must rely on to live, in order to function and survive it generates more than 1 sense of self (Ego), one which can allow the child to form a relationship with the caregiver, trust them and depend on them, and one which allows the child to see the caregiver as the terrible danger and protect himself from it. As time and abuse go on and the need for separate egos continues, they develop into separate rudimentary identities in their own right, allowing the primary ego to grow and becoming a functional person, as the sub-ego continues to absorb all the emotional damage, and continues to separate from the primary ego, taking the damage with it. As the mind develops the alternate ego can develop, fracture into more egos, or simply continue to separate, maybe even being completely buried along with memories of the abuse the child suffered, regardless, the alternate develops into one or more functionally separate personalities.

Theory 2: Similar to 1, except more clinical. The child needs
A) A capacity to dissociate
B) Experiences which overwhelm the child's ability to process
C) A separate generated set of personal characteristics to attribute to an alternate self (Age, name, gender, etc)
D) A lack of positive and soothing experiences to balance the trauma
With the above, alternate personalities naturally develop as a coping mechanism, the more extreme or numerous the traumas, and the more investment in the construction of alters, the more developed and numerous the alters. This theory means the important part of the alter to a clinician is the characteristics which differ from the primary personality, as they speak to the type of trauma which made them.


Theory 3: DID is caused when a developing mind is unable to pull all its developing beliefs, behaviours and experiences into a single unified mind due to some trauma, (using a sudden murder of a parent as an example, a friendly outgoing personality cannot coexist with the belief that at any moment, any stranger could suddenly kill a loved one of yours) so the mind divides into the "Normal every-day personality" and the "Defence Personality" The first allowing you to function normally, trust, play etc, and the second remaining vigilant and ready to fight off or escape imminent threats, the 2nd being like an in-built bodyguard, always on alert so you don't have to be. With repeated traumas or neglect the Defence personality can further divide as needed to guard against multiple potential threats.

Summary: Basically every theory is based on the idea that DID is caused when the developing mind of a child develops naturally into multiple personalities rather than 1 as a way of coping with excessive stresses and traumas around them. In cases where DID does develop in adulthood it is believed that this is a once-buried alternate from childhood being dragged to the surface again by the mind to help shield the primary personality from fresh trauma and NOT a result of the adult mind fracturing.

Sigh... There goes my evening... Interesting though.
It can also be unnatural as in my case. So not every theory. In manufactured d.i.d. the child's mind is intentionally split into different parts so abusers can use them.
 

extraterrestrialone

phoned home, no one answered
SF Supporter
#42
I understand this as I experience and have experienced similar. We call them persecutory parts.. typically imprinted by an abuser. Other people call them introjects or I've heard people without dissociation refer to it as the inner critic. These parts do lie. They don't speak the truth about your worth. They see it from their damaged perspective. The fact it's got elements of sadism makes me think it's from an abuser unless you feel you have some sadistic tendencies inside naturally. But even the name hijacked suggests it doesn't spawn from your nature, it's latched on without right.
i am not a sadistic person nor am i masochistic however when i was very young i did think of myself as masochistic. i think what drives masochism (and most likely sadism too) begins as being intermingled with sexuality and gives the appearance of possibly being pleasurable, however as time went on, i came to realize that it grew more and more independent from everything else and more and more became self hurt that i hated and could not stop. being “latched on without right” as you say is so true. hijacker freely admits that! and that is why at times i suggest that it is a demon. but that in turn makes mental healthcare professionals all the more want to fill me up with meds so that the problem appears to have been dealt with. and i don’t really believe in demons. it must be a part of me. i wish it was not so strong. i’m facing very rough and difficult feelings and experiences having gotten into an intensive therapy program and also a program for survivors of childhood sexual abuse. i’ve been feeling too intensely to even show up here for hte past week. but i’ve been saying to myself that even though it feels like the pain lately is more than i’ll be able to handle when it gets closer to beeing full out, i also know that hijacker poses a true danger if i don’t keep working in these programs. scary, but what else can i do?
 

extraterrestrialone

phoned home, no one answered
SF Supporter
#45
wondering if anyone here is knowledgeable on this subject and would like to share more information. it keeps coming up in conversation here and elsewhere. I am very sure it does apply to me even without an official diagnosis. someone I know calls ESD/DID being "Plural".
 

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