Dissociative Identity Disorder and how selves form

[1210donna]

@Waltham1892 WHAT IS A TROLL? quoting Waltham's own words: "I pay a flat fee for internet service. So, I might as well get as much use out of my monthly fee as I can. What I do is let them rave on about what they think they know, and then beat them to death with what the truth is. Then, I hit the block button and engage the next target."

[Tuckercrew]

@1210donna thats sociopathic behavior of him, he's terrible.

[1210donna]

there is no overlap between narcissistic personality disorder and DID. There is a 58% co-occurrence of Schizotypal personality disorder and DID. DID is NOT a personality disorder. That is why it was renamed from MPD, because it was understood to be a DISSOCIATIVE disorder, not a personality disorder. Though those with some personality disorders may be more prone to DID. I guess that's like saying that not all people with foot problems have diabetes though that is one source of having such.

[1210donna]

@1210donna DID is brought on by the same events that cause PTSD. It is a more entrenched form of PTSD. They are both on the spectrum of dissociative disorders. DID is more complex than PTSD. All people with DID have PTSD but those with PTSD, especially if they got it after childhood, generally will not have DID. So if you seek to understand DID via personality disorders you won't understand it.

[1210donna]

BPD is a personality disorder and is one of the 5 personality disorders that commonly co-occur with DID.

* AvPD (Avoidant Personality Disorder) had a 76% crossover .

* Self Defeating Personality Disorder had a 68% crossover .

* Schizotypal Personality Disorder had a 58% crossover with dissociative tendencies.

* BPD (Borderline) had by contrast only a 53% crossover .

* Passive Aggressive Personality Disorder had a 45% crossover .

but BPD is the most commonly MISDIAGNOSED as DID and vice versa

[Waltham1892]

@1210donna

Is this your own theory or are you citing some kid of research?

[1210donna]

@Waltham1892 if you go to my blog and type 'spectrum of dissociative disorders' you will find the article these stats are from and their source in published studies

[Waltham1892]

@1210donna

The reason I'm asking is that most Axis II, cluster B, disorders include attention seeking behaviors and labile mood as diagnostic criterial, and SPD includes bizzare beliefs and delusions in its criteria.

This would see to preclude a diaginsos if MPD/DID.

[1210donna]

Schizotypal is correlated with higher predisposition to dissociation as is BPD, but Histrionic is not. AvPD and Self Defeating PD are among the least attention seeking of all PDs yet are more highly correlated with DID than even BPD. So predisposition to attention seeking has no correlation with responding to trauma through excessive dissociation. However, attention seeking PDs have a high correlation with Munchausens and DID attracts a lot of such tourists'.

[Waltham1892]

You are mixing your terms.

Schizotypal and Schizoid are classified as PD’s, but they are more correctly Schizophrenia Spectrum Disorders (Positive v. Vegitative symptoms).

Axis II, Cluster B disorders (Borderline, Narcissistic, and Histrionic) are HIGHLY correlated with attention seeking behaviors.

My point is, given that attention seeking behaviors are part and parcel of an cluster B, how can you prove DID is an valid diagnosis?

Maybe DID is a social construct?

[1210donna]

BPD was found correlated with DID (53%) but Histrionic and Narcissistic not at all, HENCE it is not attention seeking of BPD that predisposes those with BPD to DID, but tendency to DISSOCIATE, which is far more highly correlated PDs of AvPD, Self Defeating and Schizotypal PDs (76%, 68%, 58% crossover respectively). In other words, those with DID were more likely to have personality traits prone to DISSOCIATION and similataneously develop the associated PDs.

[1210donna]

70-80% of those dx'd with autism fit Schizoid/Schizotypal PD profiles. But Autism was distinguished from schizophrenia since the 70s, as were these two PDs. The SPECTRUM of schizophrenia can include anything that predisposes (and wiki says AvPD does too!) just as the SPECTRUM of DISSOCIATIVE disorders incl derealisation, depersonalisation,... experiences you or any HUMAN probably have and remember given the stats, 25% of those with DID have no PDs at all!

[1210donna]

I think you are really struggling to distinguish DID as part of the spectrum of DISSOCIATIVE disorders from things like Munchausens, somatoform disorders, and this would include the old dx of 'Hysteria' which then became MPD, which is now considered a defunct diagnosis and in that process those with somatoform disorders were distinguished from those experiencing dissociative disorders... and remember ALL human beings dissociate, just not usually to disorder proportions.

[Waltham1892]

@1210donna

Dissociation is a common human experience, I've experienced it myself in times of crisis.

However MPD/DID is something yet again.

There is no scientific explanation behind DID as many of its underlying precepts are untestable.

DID is also based on a model of human consciousness that was disproved half a century ago.

That leaves few explanations left, Conversion Disorder being one them.

[1210donna]

recent brain studies found related neurological differences in those with PTSD and DID. This does not mean it will apply to MPD. DID is simply 'complex PTSD' which additionally identity cohesion/development when a child under 3-6 yrs old experiences repeated severe and chronic trauma. It is also known that severe child abuse causes neurological differences.... the brain simply can't develop normally under those conditions. These things are in the neurology journals.

[1210donna]

yes MPD is defunct, we ALL have multiple personality traits which appear in varying combinations in different situations. DID is complex PTSD but differs in that its development is before the age of 3-6 so has a different impact on identity development. Those with DID do NOT have multiple PERSONALITIES. They have multiple IDENTITIES a lack of COHESION/AWARENESS between these identity states.

[Waltham1892]

@1210donna

The problem with these studies is that they lack most of what makes a study scientific, an underlying theory, control groups, and replication.

They also tend to be conducted by clinicians and not researchers, and as a researcher I can tell you these studies will not replicate due to fundamental errors of design.

If you would like to take a stab at offering the underlying mechanism of DID, I would like to hear it.

Also, Complex PTSD is BPD.

[1210donna]

Those averse to the label of BPD have PROPOSED it to be called Complex PTSD but studies have found that most cases of BPD unfortunately do not include a PTSD component nor childhood trauma. This is probably why those cases where there's a 53% crossover between BPD and DID would qualify as complex PTSD but this would be so even if the person had only DID and no BPD (and 47% had no BPD, though 76% had AvPD so by your logic AvPD would have equal status as 'complex PTSD')

[1210donna]

@Waltham1892 so i guess you could say that DID is complex PTSD in any human being who develops it regardless of whether they have an additional PD or not, and that there were 5 PDs correlated with DID of which BPD was the 4th most common, so it cannot claim any sole claim to 'complex PTSD' no matter how convenient that may be given the stigma of BPD dx.

[1210donna]

@1210donna and yes, the studies are by clinicians in medical, psych, neuro journals so that's good enough for me. As a layperson, the mechanism as i see it is that a) all humans are capable of defence mechanisms on the dissociative disorder spectrum - depersonalisation, derealisation, dissociation, and all are capable of experiencing trauma, or severe chronic trauma, or in the years before 3-6 when cognition/neurology/identity are developing/organising

[1210donna]

@1210donna now b) all humans will have around 4-6 dominant personality traits.... some of these are more predisposed to develop certain skills or associated weaknesses. one of these skills is dissociation.... or the weakness of staying present in the body, mind, emotions during challenge/trauma. IF severe chronic trauma occurs inescapably, continually on multiple levels in formative years before 3-6, then those with these traits would be more likely to RESPOND dissociatively.

[1210donna]

@1210donna c) where there is intervention in childhood, this has been turned around, where dissociative strategies have become so automatic, instantaneous and beyond the child's control, then without intervention, this becomes their 'default' state and 10, 20 years later, then outside of the abuse situation, this progressively presents as dysfunctional/disabling. 

[Waltham1892]

@1210donna

Again, how can a human brain, the most interconnected structure in the galaxy, have "seperate" centers.

The only explanation is a delusional system with one person, one personality, one mind, one brain, but different selected presentations.

I am not the same man I have at home as I am at work. I am a different man with my students as I am with my clients. However I present though, I am always the same man.

[1210donna]

@Waltham1892 and here you describe wonderfully the difference between compartmentalised functions that over time have formed into distinct identities in a person with weak central coherence versus someone geared for compulsive attraction toward new roles, role playing, etc... DID is the former, BPD is the latter, and clearly 53% of DID clients fit both, but many human beings will have some elements of each because it is simply a human phenomena, no more, no less

[Waltham1892]

@1210donna

But then the paradox's settle in.

In order for DID to function the core personality needs a distinct memory and executive functioning. Then each alter must both as well. Now you need another independent executive fuction with its own memory to manage them all.

However, given what we know about the massively interconnected architecture of the human brain, with its parallel processing system, where are all these distinct structures?

Its beyond reason.

[1210donna]

@Waltham1892 I feel my core self was so depersonalised that it lost all personalisation of the body, emotions and thoughts about experiences... they were stored as if they belonged to someone else... in this sense my core self was dormant- present, recording, but other compartments were responding -if you like functions of the brain that developed into compartments.... the function to divert into work, to take all responsibility/guilt, to laugh everything off, to echo TV characters

[1210donna]

@1210donna so this is just an extreme of the normality of all humans, just overdeveloped compartmentalisation of mental functions and eventually the connections between compartments weakens because the person's environment necessessitates survival depends on retaining the lack of 'conclusion', realisation, which of course comes with cohesion... when the core self awakens, thaws, or un-depersonalises, this becomes possible

[Waltham1892]

@1210donna

What I am saying is that when two disorders have a very high level of co-occurrence, such as over 50% people having a diagnosable level of disorder "A" while having disorder "B", maybe disorder "B" does not exists.

Again, BPD is well understood and well explained. DID is a paradox.

And, as you have pointed out, maybe the stigma attached to BPD makes presenting with DID, which has the virtue of being novel, a more appealing option to someone seeking treatment?

[1210donna]

I don't see why the fixation on BPD....

*AvPD (Avoidant Personality Disorder) had a 76% crossover .

* Self Defeating Personality Disorder had a 68% crossover .

* Schizotypal Personality Disorder had a 58% crossover with dissociative tendencies.

* BPD (Borderline) had by contrast only a 53% crossover .

* Passive Aggressive Personality Disorder had a 45% crossover .

there's no mystery in trauma increasing chances of also having a PD associated with high tendency to dissociation

[Waltham1892]

@1210donna

My fixation with BPD is that, as William James pointed out, the mind can do nothing which the brain can not do.

The human brain can not be divided as DID requires. However, the brain and mind can present as a matter of choice.

Who would seek such a tortured and crooked path as fabricating the three ring circus of DID?

Answer, Borderlines, who walk a tortured and crooked path already.

[1210donna]

@Waltham1892 I personally don't feel that the DID brain is divided... but that it is over compartmentalised from such a young age and that compartmentalisation not treated or overcome, then later that same compartmentalisation in adulthood presents dysfunctionally. I know around a dozen people dx'd with DID... I have personally met with three of them on an ongoing basis... none of them had any dx of BPD nor symptoms of BPD, none presented as MPD types like on youtube/media.

[Waltham1892]

@1210donna

The brain is a hyper-connected system. There are more synapses than there are stars in the known universe.

Compartmentalization is impossible.

Further, you can not have a personality without the frontal temporals, temporal lobes, and the limbic system. While you can claim X many personalities, you only have one of each of these structures.

I too have met, and treated, several DID's. All were confabulating their symptoms, all were BPD's.

Are you a clinician?

[1210donna]

@Waltham1892 are you in he USA? here in Australia, dx of DID is very uncommon. Hence I think it might be that in a country like the USA you might find a higher number of clients presenting as DID who actually just have BPD. I was dx'd when I was sent by my GP for a review of my medication for mood, anxiety, compulsive disorders. I was shocked when he said I was Schizoid and had DID. I'm an autism consultant, have been since 1996, hence seen a lot of overlapping 'fruit salads'.

[Waltham1892]

@1210donna

Excuse me, Schizoid and DID?

I don't like to question another clinician’s judgment, but you have to be kidding me. The diagnosis of either makes the diagnosis of the other impossible.

I think I'd get another opinion.

I also think I'd report the clinician who offered the diagnosis to their licensing authority.

[Tuckercrew]

@Waltham1892 I personally know the Dutch expert on DID, she'd laugh at you. Its clear youre a troll, and a sociopath, too.

[1210donna]

@Waltham1892 I also had skype contact with two who had dual dx of BPD and DID and email contact with another with same dual dx. I ended up finding all three to be highly disturbing, highly imbalancing individuals. I also knew of someone with dual dx whose therapist consulted me and my advice was that the person's BPD issues were FAR overriding the DID issues she may have also had.

[Isochest]

I've got to get my head round this: What brings this on? Narcissism & Schizotypal disorders I can understand but this is another!!?

[1210donna]

DID is not a personality disorder. It is a DISSOCIATIVE disorder. PTSD is ALSO a DISSOCIATIVE disorder. DID used to be MISTAKEN for a personality disorder and called MPD which has since been quashed completely in the DSM... I guess just as people once thought things like Autism was mental illness. Yes, some personality traits PREDISPOSE people to DISSOCIATE when faced with severe trauma. But Narcissistic personality disorder is not one of them, though Schizotypal is.

[dahgooch]

Are you whispering? Why?  I can' hear anything.

[1210donna]

@dahgooch please look up selective mutism. Some of my selves can only speak internally, others can only type, some were selectively mute most of our lives. Selective Mutism causes high fear when hearing one's own speech so the throat closes up and to push it causes cesassation of speech.

[1210donna]

it is not true at all that those with DID don't switch when with one person. I know others with DID who switch all the time, alone, with others etc. Sometimes an alter will dominate for a day, week, month, months, even years, but there's no one size fits all DID.

[gimmealiteracola]

What would be interesting is if someone with this disorder was being recorded 24/7 for just a week. That way you could really tell what behaviors they exhibited whether or not they were in therapy or what. When people with this disorder are around more than one person they dont seem to switch or have ticks like people with tourrettes syndrome do. SO it would be interesting to see what theyre like when they forget theyre being recorded.

[ksol1460tv]

@gimmealiteracola I know someone who volunteered for this for an independent film. But because they just did normal everyday things, it was decided not to make the film because while you could tell there were different persons present, they didn't act "crazy".

Chris

[1210donna]

@gimmealiteracola this may be a difference between roles in BPD versus alters in DID in that those with BPD who keep falling into roles may be more subject to the 'audience' factor. Those with DID who have alters rather than roles are often triggered by internal memories, objects, even smells, trigger words... so may be less likely to be audience dependent. However those with DID with Schizoid, Schizotypal or Avoidant PDs may have alters that 'disappear' with certain people more than others. 

[ouneouneouneoune]

awww

[1210donna]

There's some interesting articles on DID over on my blog... one features a PubMed article re crossover of PDs and DID. BPD had around a 50% crossover but other PDs like Self Defeating, AvPD, Schizotypal had far higher crossover. Only those with BPD are prone to constant role playing. My experience is DID in someone with BPD is different to that in someone without BPD. I also have some clips when I'm aged 12 of me switching... its not like acting at all.

[ilissabanhazlmft]

I am a marriage and family therapist and I have seen individuals disassociate. I know that the disorder is controversial in terms of the psychological community accepting this disorder as real. When you see it, it can look like acting. I'm really not sure what I think about it. Whether it is real or not, I believe it is a coping skill for trauma.

[blyth1972]

I have found what you have said fascinating. I admire how you refer to your system as a 'team' because it indicates great mutual understanding and appreciation of your selves. Do you find that your 'core' self is co-conscious while your alter selves are 'out'? Or does your core self become absent during these times of transition? I am very interested by different forms of D.I.D., as just about every case seems different and therefore unique. Thankyou very much for sharing!

[1210donna]

@blyth1972 My Core self prior to last year was more like a stenographer, just a note taker, everything else shut down. Since becoming the host (after 44 years in that semi dormant state) my core self is often co-conscious now when others are presenting and has reached a point it holds back to facilitate them presenting so they can resolve/express what they need to, but my core self is now so integral it could step in if needed. There are times, yes, it still goes dormant but only mins/hrs now

[hallucinogenic1]

Omg I wish I could hear this. My speakers are on max but the volume is still too low :(

[1210donna]

sorry its not working for you. I do get quite quiet at times there. Used to deal with Selective Mutism so was doing my best but volume can be challenging.

[hallucinogenic1]

@1210donna It's okay! It's probably just your microphone! I will wear headphones next time =)

[lmollot]

yes- i fell asleep eyes staring at light-recurrent nightmare of faaling of building feeling pain as i hit pavement- this may be so i woulld wake up to be on defence from abuse- severe tics-sleep walking-sleep deprived-teachers legal abuse of us didnt help

[myranagels]

So much respect 4 you!!!!!

[1210donna]

@krstcmjns It is the case that there's a genetic predisposition to high ability to dissociate and tendency toward PTSD. However for that to progress to DID there's usually extreme ongoing childhood neglect, loss, trauma, abuse, but, yes, it is certainly both developmental and psychiatric.

[fawnknudsen]

Subtitles, please.

[dithorsos]

My mother also does not fall asleep easily. She too is afraid of the dark and leaves a lamp on by her bed to get to sleep. I am wondering if this is a causal factor in her dealing with cancer.

[1210donna]

@dithorsos Hi Di, I think any unresolved significant fear is not good for the immune system and cancer is immune related. We need sleep-dark cycles to regulate brain chemistry and reach REM sleep which is essential for health. A small plug in night light would at least be a step closer to that than a lamp on all night.

[springrobin]

The actual feeling of dropping off to sleep terrifies me, feels like a total outta control feeling so i have to be totally sleep deprived so that I'm basically so tired i'm falling asleep standing up. And i finally fall asleep sitting up. That way the length of time it takes to actually drop off is reduced. I'm an autie & have DID too, thx Tina

[1210donna]

I slept with my eyes open until age 10 and by then had awful OCD about rooms so had to check and recheck every inch for burglars. I also believed that if I slept exactly in the middle nothing bad could happen but then was so terrified I'd make a wrinkle or move I couldn't sleep, Then in my teens I self medicated to sleep, I was just so terrified of it. By adulthood I could sleep with low lighting but still some panic in the dark.

[springrobin]

Donna I'm an autie and have DID too. I'm 45yrs old and still have real trouble sleeping in a bed - sleeping period actually. Seems like til just recently I found it more easy to go extremely sleep deprived. I think now maybe cos I'm older it's getting harder to burn the candle at both ends or maybe just cos I've done it for so many years, my whole life. Do you have any tips on what I could try or what has worked for you to help you sleep, reduce the anxiety of.

[springrobin]

Hi donna thanks for your bravery in sharing this. Do you happen to know of any body of work and/or research looking at the links-similarities between autism and the dissociative processes.

The TJ's