Not Alters - Aspects?

[greenleaf]

The idea of an ANP and an EP, kept determinedly, even phobically, apart, make such sense of my experience - when I am stable, being in any other state seems impossibly unlikely, and when I am distressed recovering from that distress by any but self -destructive means seems incredible. It makes sense of why I walk into therapy and can't really recall any bad bits of the week to report, even though I know it has been up and down. If at that moment I'm functioning as ANP, then I wouldn't want to know about the EP bits.

This sounds really familiar! I can really related to just sort of keeping a dry mental outline of difficult periods but not staying in them really, so the details can take real will to retrieve -- or just be missing. The phobic thing makes sense...

As an aside... I think that some of the really recent Dutch trauma research uses the phrases"less than distinct parts" and "distinct parts" instead of "ANP" and "EP".
Link Removed

The Internal Family Systems (IFS) model can be used for both dissociated parts and "normal" aspects of personality -- everyone has those latter things, including people with dissociative disorders, I think. People can mostly all relate to, say, a "work persona" and a "with your buddies" persona.

However I find the Structural Dissociation (SD) model much better for specifically explaining some issues I have that were related to abuse. The IFS "roles" for parts seem less explanatory to me since I can apply them in different ways, IFS seems like storytelling to me (helpful but not explanatory) whereas SD feels like the engineering and things fell into place for me too when I read it the first time.

Maybe the phobic boundaries between parts in SD is the difference from "normal" parts in non-SD people? There is some physical evidence that unprocessed traumatic memories are stored physically differently in the brain than normal memories; the unprocessed traumatic memories would be held by EPs or less than distinct parts in SD.

 

[Chava]

Maybe the phobic boundaries between parts in SD is the difference from "normal" parts in non-SD people?

I think the difference would be the trauma. So they are not just like different personas, but hold trauma experience, so are not adapting to a present situation like a persona would, but being easily triggered by it in some cases and reacting to it as if stuck in the past.

I don't have phobic boundaries exactly, but have been scared of my self-destructive parts...hard to trust myself. It's coming together though. And I think I've been lucky to acquire some small buffer between parts through the years...stuff like AA and being able to be a little vulnerable or less-than-perfect or my good workaholic self...though even in AA I somehow came across as much more put-together than I actually am. When I started crying at a meeting after a decade, I freaked some people out. But the parts that have shown up in therapy have never felt okay in the real world of other humans...they are terrified, mute, very disorganized...and I think why I feel an extra need to isolate through some of this. I'm feeling protective, letting this stuff integrate hopefully vs run far underground.

It's just bizarre to me that complex trauma isn't yet addressed somehow in the DSM. We have trauma experts like Judith Herman and Bessel Van Der Kolk proposing models that encompass all of these symptoms, and this overlooked structural dissociation stuff (Just looked up the book, "The Haunted Self" about chronic traumatization). Instead we get a glob of different diagnosis, unless we're lucky enough to find a therapist who simply understands the complexity of multiple, developmental, or chronic traumatization.

 

[Sandstone]

The UK is so geographically close to the Netherlands,

Specially for me. Where I live, the closest motorway is in Holland, not in the UK.

Is there any support in place for when your 16 sessions are up

T says she will let me know when she finds out. I'm really not sure what impact any additional diagnosis could have. I've seen it suggested that DID people can be denied treatment in the UK, because they are" too complex". Having fought over three years to get the treatment advised by NICE for PTSD, it doesn't sound hopeful.

It's just bizarre to me that complex trauma isn't yet addressed somehow in the DSM.

It looks as though it will be in the ICD 11 though, defined as
"Complex post-traumatic stress disorder (Complex PTSD) is a disorder that may develop following exposure to an event or series of events of an extreme and prolonged or repetitive nature that is experienced as extremely threatening or horrific and from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. In addition, complex PTSD is characterized by 1) severe and pervasive problems in affect regulation; 2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the stressor; and 3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning."

As an aside... I think that some of the really recent Dutch trauma research uses the phrases"less than distinct parts" and "distinct parts" instead of "ANP" and "EP".
Link Removed

Interesting. I shall read this tommorrow - Less than distinct parts sounds very much closer to aspects.

the parts that have shown up in therapy

I was about to say - there you are - no other aspect has ever done that. This is less relevant to me than I thought. Then I recalled the session two weeks ago, about which I posted

it was so hard to take in what she was asking and compute an answer. I kept having to close my eyes to focus on being able to speak. She said I looked as if I was in pain as I tried to force my brain to function.
I felt that she just didn't know what to do or say, which I haven't thought before. She said she was worried about me, but I told her that this isn't all that unusual for me, it just hadn't fallen on a therapy day.

Bum!

 

[Ronin]

T says she will let me know when she finds out. I'm really not sure what impact any additional diagnosis could have. I've seen it suggested that DID people can be denied treatment in the UK, because they are" too complex". Having fought over three years to get the treatment advised by NICE for PTSD, it doesn't sound hopeful.

Yep, I'd be careful of that. When the therapists (thinking the British ones I've had, hence bringing it up) finally stopped misdiagnosing me as borderline one flavor or another thanks to D.I.D., they basically washed hands off that with stating D.I.D. is entirely outside their realm of treatment and had no one to refer me to, with provided reasons being 'too complex' precisely.

 

[Chava]

I've seen it suggested that DID people can be denied treatment in the UK, because they are" too complex".

I'm sorry...didn't realize what the situation was in the U.K. That's really terrible (not like we have it very good over here).

It looks as though it will be in the ICD 11 though, defined as
"Complex post-traumatic stress disorder (Complex PTSD) is a disorder that may develop following exposure to an event or series of events of an extreme and prolonged or repetitive nature that is experienced as extremely threatening or horrific and from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. In addition, complex PTSD is characterized by 1) severe and pervasive problems in affect regulation; 2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the stressor; and 3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning."

I hope so!! This makes so much sense to me. But I hope in the U.K. it's not seen as too complex, like D.I.D. "Too complex" is a really shitty way to give up on people. There are therapies that can help. My therapist has said some of my really deep patterns are almost intractable, but she was also clear to say it is not IMPOSSIBLE to change. I'm handling many things better, and accepting my limitations as well. I feel like I'm really struggling with the human connection part...and ultimately don't know how much can be repaired there. But instead of pure shame I am more willing to recognize what kinds of connections or social things feel good (I'm crazy ass picky).

Not sure if it helps, but it does sound hopeful that your therapist is really interested in learning about your different aspects. I grew up in an abusive and entirely emotionally void/negligent home. I am hyper aware to what I think others want from me or want me to be. I've often felt like a chameleon. My last therapist made me feel like I had to be positive, assertive, and sort of sarcastic. I sure she didn't mean this. But that's the vibe I got and I never felt okay to be really vulnerable, or my mute self that needs to just quietly FEEL that the situation is okay and my therapist can just witness that and remind me that I'm okay by her non-reactive presence. Whether DID, CPTSD, or PTSD with some DDSNOS or structural dissociation, we are really only safe if the therapist doesn't unwittingly expect us to be one certain way.

 

[Sandstone]

It's just bizarre to me that complex trauma isn't yet addressed somehow in the DSM. We have trauma experts like Judith Herman and Bessel Van Der Kolk proposing models that encompass all of these symptoms, and this overlooked structural dissociation stuff .

Was just looking at Dissociative Disorders in the proposals for ICD11
There is
"7B37 Complex dissociative intrusion disorder

Definition
Complex dissociative intrusion disorder is characterized by the presence of two or more distinct, nonintegrated or incompletely integrated subsystems of the personality (dissociative identities), each of which exhibits a distinct pattern of experiencing, interpreting, and relating to itself, others, and the world. One identity is dominant, but is persistently and recurrently intruded on by one or more other dissociative identities, although these do not take full control over the person’s consciousness and behaviour. Dissociative intrusions typically involve a combination of cognitive, affective, perceptual, sensory, motor, or behavioral features. The symptoms are not consistent with a recognized neurological disorder or other health condition. The disturbance is sufficiently severe to cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning."
That sounds like my experience of "It can't be true/ It has to be true" and all the other stuff

 

[greenleaf]

Was just looking at Dissociative Disorders in the proposals for ICD11
There is
"7B37 Complex dissociative intrusion disorder

Thanks for posting that, Stenni. It seems to overlap a lot, intuitively at least, with "DDNOS", secondary structural dissociation... etc. Why do people have to keep coming up with new disorder names all the time? Do they get their names on it then? Argh.

Also, it doesn't seem to mention trauma... is that in the parent category?

 

[Sandstone]

No, there is no mention of trauma in any of the Dissociative Disorders I've looked at. I'm speculating that people would get both a Dissoc. diagnosis and a Disorders specifically associated with stress diagnosis

 

[ihateusernames]

I'm so glad you posted this, @stenni. This is something that has been bothering me, too, although I haven't exactly had the same experience as you. I haven't had a therapist tell me anything like this, I haven't been seeing a therapist. I stupidly got on Google and ultimately filled out that damn dissociative experiences scale online. Scored so friggin' high, and then casually mentioned it to some people fishing for what they felt was "normal" in those areas. Turns out, according to them, I'm completely crazy. So I've been putting more effort into finding a new therapist because I would really like to know what somebody who has actual experience with this stuff has to say about it. Not just my dingbat friends who think everything is weeeird. ;)

Anyway, I'm glad you came asking, the responses here have been very helpful to me, as well, and I can relate to so many of the things being discussed it makes the prospect of potentially uncovering a dissociative disorder, whenever I do get back in to talk to somebody, a whole lot less scary.

 

[Sandstone]

As ever - beware of self diagnosis, and of therapists who see the same condition in everyone.

 

[ihateusernames]

therapists who see the same condition in everyone

I would expect that a therapist who saw the same condition in everyone would recognize that what they are seeing is normal behavior and not a disorder. But I can imagine that's far from some of their minds. That's a big part of why I have avoided therapy for so long and probably part of why I have had one foot out the door any time I have been in it. I don't want a bunch of diagnosis. I don't want everything I do pathologized. Is that a word? I'm going to make it one. When those things are just normal human things.

 

[greenleaf]

@ihateusernames -- some Ts recognize that the list of diagnoses changes every couple of years, so they don't throw the words around... The diagnoses tend to be surface descriptions sometimes too... symptom lists not underlying causes, and some of us have somewhat shifting symptoms (or greatly shifting symptoms) as time goes on... the cause and what we need to work on might have stayed the same though.

I do hope that the MRI and neuroscience work catches up a bit! DID has some MRI verification now but not many other related issues do (so far as I know.)

So anyway, my current T hasn't mentioned specific diagnoses from a manual, but has mentioned numerous words that appear in such places where they are helpful. Maybe she has a diagnosis but those are more for insurance or maybe hospitals for communication between professionals too? Please don't think that you need to avoid all Ts over this issue though, some really focus on your individual issues completely.