DID
Personality states in dissociative identity disorder

The parts that make up the personality system of an individual with dissociative identity disorder have historically been called alters (altered states) and host, but these terms are limited as will be explained further down on this page. There are also other more general terms that are used interchangeably including personalties, parts, states, subpersonalities, sides, subselves, internal self states, ego states and so on. (Noricks, 2011, p.1)

1. Parts terminology


The DSM-5 terminology
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) refers to distinct, dissociated parts of the personality as personality states, (Howell, 2011 p.55-57) but it's understood that in this context the states lack the continuity experienced between normal personality states.  [Boon, 2011, p.25]  In fact, they can also exhibit differentiated aspects like speech mannerism, physical behavior, handwriting, somatic illness, sense of body and autobiographical history.


II. Personality

Personality is complex, exciting, immense and utterly fascinating
The personality is an enormous array of patterns, impulses and complexity that goes beyond current human comprehension. Understanding of the processes is limited, but we do know that the personality is certainly not one merged working unit. Instead it can be looked at as a network of complicated reactions that execute behavior.

Apparently normal part (ANP) and emotional part (EP)
Authors are starting to replace outdated language with more accurate terminology. The words alter and host no longer can explain what is known today about dissociated personality states.

The problem with host and alter terminology
If the terms alter and host are to be used it should as follows: A host is any part that is in executive control at any given moment, and an alter is any part including the host. It should also be understood that all parts experience major deficits in self-awareness and functioning including the part traditionally thought of as the host.  (Howell, 2011 p.134) In addition, no part is the original, and there is no part to "integrate back into" which is commonly thought. (Howell, 2011 p.59)

ANP and EP terminology
This site will often use the terminology apparently normal part (ANP), and emotional part (EP) which will help the reader better understand dissociative identity disorder.

ANP and EP can both take "executive control" of an individual
Both ANP and EP can take executive control, but once an individual is an adult and in a safe environment the ANP is in executive control the majority of the time, however when the individual is a child and in constant danger the EP might be the one who is most often in executive control.

Mixture of ANP and EP
Severely abused children can have parts that experience themselves as a mixture of both ANP and EP. . This feeling or experience does not change the specifics that make them either one or the other. The EP is trapped within their own dissociative boundary, reliving a tortured life of neglect and abuse, and the ANP is trapped within their dissociative boundary and avoidant of the trauma memories held by the EP. Many individuals with dissociative identity disorder will never remember or even know of their child abuse or their mental illness due to the dissociative boundaries around them.

Two ANP, two EP and one observing EP equal DID
For an individual to have dissociative identity disorder they will have at least two ANP and at least two EP, as well as an observing EP (historically called ISH). No other disorder has more than one ANP, however it's rare that the individual with dissociative identity disorder knows they have more than one ANP, so obviously this is not the best criteria to diagnose the disorder with. The observing EP is unique in that it has the ability to see, hear and be everywhere inside at the same time. People without dissociative identity disorder also have an observing part which is usually called a hidden observer.

III. Amnesia

Contrary to popular belief, not all parts have amnesia between them
The idea that all personality states in individuals with dissociative identity disorder have amnesia is a simplified media presentation and a misinterpretation of the DSM. In fact, by the time an individual is an adult, or at least after they have done work leading to communication between states, then they have probably obtained a great deal of integration. (Howell, 2011 p.7-8)

Integration is an ongoing process
Dissociative boundaries that are highly impermeable are responsible for the lack of integration between dissociative states, (Howell, 2011 p.4, 134) and the goal of therapy (or self work) is to break down boundaries and allow communication between the parts. Each time an ANP or EP become closer to one another, they are integrating. What many call coconsciousness and copresence is simply a marker showing the ongoing process of integration .

Unification - the normal mind
Some will incorrectly call a certain point in healing integration, but integration is a process, not an end. Unification or fusion are better terms. This is when the symptoms of dissociation are gone and trauma memory is no longer reactive because it has moved to a narrative form. The term fusion might be more common, but there is no fusion of parts so the term is misleading.

Integration work beyond unification
Integration can be an ongoing process performed by those who have obtained unification, as well as those who have never had dissociative identity disorder. Dr. Daniel Siegel has done a great deal of work in this area. See for more: 9 steps of integration by Dr. Daniel Siegel

IV. Amnesia for amnesia

A part can't recall what they were not present for
ANP are in executive control a great deal of time once an individual is out of danger, leaving an adult unaware of the events of their own childhood. ANP were not usually conscious during the abuse that led to trauma, and they can only recall the events they were conscious for, or have integrated enough to share memory. The part in executive control is often oblivious to their own childhood abuse or trauma.

The elusive ANP
Even after all EP are well known, many individuals are still clueless about having more than one ANP because the various ANP can be so similar that they switch between themselves repeatedly and the part in executive control doesn't have any idea it's happening. More often than not, the observing EP is the one that has this knowledge but they don't usually share it unless asked.

V. The inner world

Within the periphery of the subconscious
ANP and EP can both exist in an extravagant venue enhanced by imagination, fear, desires and external and internal experience. It can be a cold, dark place where there is nothing but empty space, or it can be a magical playland filled with fun and games, but usually it's something in between. This is the inner world that is visualized, heard, felt and experienced as real by both EP and ANP. (Howell, 2011 p.57) In this world parts do not tire, they do not sleep and between them all, they can carry on a variety of different activities at one time.

Dead, missing, floating EP and ANP

Some, if not all, EP and ANP might "float," either unaware of time passing or are trapped and lost (thought dead) and painfully all to aware of the passage of time. They cannot be killed, but they certainly can think and feel they were killed and be almost impossible to find.

The inner world is the "hangout" for all not in executive control at the moment
The inner world is where all ANP and EP are when they are not the one in executive control. Even though this inner world is an active place, many people with dissociative identity disorder don't have a clue it exists. All they know is their experience during the time they are in executive control, due to the dissociative boundaries that contain them. Once they are in the latter part of phase II of therapy the parts are usually able to travel back and forth from the inner world of the unconsciousness to consciousness.

EP and ANP actualization
EP rarely look like the individual, so if they look down at the individuals body and see the way they look in the inner world then they are confused. An example of EP actualization would be a furry little guy who is concerned about hiding his tail when he is in executive control. A simple suggestion is all it usually takes to remedy the situation and instead of seeing how he appears in the inner world, the little guy can learn to see the individuals body instead.

An EP can take any shape or form
In the inside world each ANP and EP have their own appearance, and they can be as big as a house, or microscopic. There is literally no end to how an ANP or EP might appear inside. They can be bloody, broken, missing limbs, blind, deaf, human or not. The ANP, no matter how they look inside, probably see themselves as the actual way the body appears when they are in executive control. Inside they each have their own appearance, just like the EP do.

VI. Switching

Switching between ANP & EP
Those with dissociative identity disorder switch, replacing or partially replace the one in executive control with another ANP or EP when there is a perceived threat. Switching allows a distressed ANP or EP to retreat while another part comes forward to handle an emerging situation. (Herman, 2012) Sometimes this change in command is good, and other times it's not so good.

Full switching includes amnesia for the one who was in executive control
Full switching is when the switch between ANP or EP is accompanied by full amnesia. (Howell, 2011 p.4-6) The ANP in executive control goes into the inner world and stays there until triggered to return to executive control. The observing EP can usually see a part disappear when they leave the inner world to be in executive control, then reappear inside when they are replaced. The part presenting as the individual, due to the dissociative boundaries, will usually be totally clueless as to what happened.

Switching between ANP
Switching can be far less dramatic as well. For instance ANP can and often do switch throughout the day depending on the job they are triggered to do. One might have the job of sleeping, another one goes to work, another one drives, another one interacts with the family and so on.

Partial switching is without amnesia
EP can influence the ANP that is in executive control, and control a situation without taking over fully. (Dell, 2006) Examples include limbs and facial muscles moving on their own, smelling an odor, emotions that are not ones own, and so on. In addition, partial switching can be recognized as withdrawal of experience resulting in a lack of thought and emotions. (Howell, 2011 p.4-6) This type of thing is not limited to just those with dissociative identity disorder like full switching is.

VII. Dissociation

Structural dissociation
There is current debate on the definition of dissociation but the authors of the model of structural dissociation appear to have the best working idea at the moment. In the mainstream, the word dissociation is used to mean anything from day dreaming to dissociative identity disorder. The authors of the structural dissociation format use the term dissociation to mean only those individuals who have an EP. Therefore dissociation applies to acute stress disorder (ASD), posttraumatic stress disorder (PTSD), dissociative amnesia and fugue, depersonalization and derealization, complex posttraumatic stress disorder (C-PTSD), other specified dissociative disorder (OSDD), trauma related borderline personality disorder, and of course dissociative identity disorder (DID).

The definition of dissociation summarized
"Dissociation in trauma entails a division of an individual's personality, that is, of the dynamic, biopsychosocial system as a whole that determines his or her characteristic mental and behavioral actions." In addition, each part has at "least rudimentary first-person perspective," and "particular psychobiological boundaries that keep them divided but that they can in principle dissolve."

See for more: dissociation.

 

 
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