Theory Vs Diagnosis (structural Dissociation)

[Sideways]

I've had a lot of trouble getting the theory of structural dissociation to resonate for me.

The way that I experience dissociation (I have DID which is probably relevant) is that the seperation isn't an "emotional" state. My dissociated parts carry all of my characteristics that relate to the event that created them to compartmentalise. So, my 12 year old part isn't a single emotion, it's the whole gamut of emotions I experienced during that trauma. On top of that, that part carries more than just emotions - it carries all the behaviours, thoughts, and memories that I exhibited during that trauma. If I were to apply the idea of a cognitive "phobia" related to that trauma, the phobia is more accurately described of the entire experience, not just the emotions.

Interestingly, you're right - we don't argue about whether or not a person has smallpox. But then, we don't tend to argue about whether a person has, say, schizophrenia. And we also can't provide a clear 'diagnosis' about why some people could care/nurse a person with a contagious illness (from the flu to bubonic plague) without contracting it, while others will contract the illness with very minimal exposure to it. Much like mental illness, we have to resort to theories about genetic predisposition, immune development, and even social factors, to explain why that happens.

I think, for a lot of medicine (not just mental illness) we have a perception that the lines are clear, when in fact, a lot of it is still just theorising and guesswork.

 

[anthony]

Mental health diagnosis is nothing but theory. To date, factually, there is zero scientific evidence to support any mental health diagnosis, let alone science to validate the underlying mechanism of causation. Theory, statistics and hypothesis = mental health diagnosis.

 

[BlueOrange]

I'm not sure about life threatening trauma always creating a new "part" - that would suggest that everyone who has experienced trauma goes on to experience some form of disorder which is simply not backed up by research.

I agree. I was using the term 'part' very loosely, and not using it to describe what is meant by 'part' in the theory of Structural Dissociation. Communication from my end was pretty poor. (1am is when the ideas come, but not necessarily the best time to talk about them...)

I think that if we experience a terrifying/horrifying encounter with death that it's inevitable that a 'new cognitive formation' will be created. We may or may not dissociate from the new cognitive formation (many tribal societies deliberately induce these experiences in order to teach lessons in an initiation to adulthood, and the religious leaders assist with integrating the cognitive formation into the mind-as-a-whole). If we dissociate, we may or may not fail to reintegrate the dissociated mental formation when the emergency is over. If we fail to reintegrate, then we may or may not develop a phobia of the mental formation. Only if we progress all the way down that line do we form a 'part' in terms of the theory of SD.

If my theory of part-formation is accurate (the fact that it makes sense to me is a start, but theory-testing is a complex business), then the 'family that discourages communication' can be explained as a risk factor for PTSD: by encouraging dissociation, and by discouraging communication processes that could assist re-integration, the process of part-formation is more likely to proceed towards structural dissociation. Conversely my theory predicts that a person who is able to accept distressing emotions, is able to obtain assistance with integration, or whose fear responses are moderate (not phobic) should be less likely to develop PTSD in response to an equivalent event.

 

[BlueOrange]

Mental health diagnosis is nothing but theory.

Pretty much. I wouldn't go so far as 'zero scientific evidence', but I do agree with Popper that a properly-formulated scientific theory makes predictions that can be tested, and that most statements about psychology are pretty weak. Structural Dissociation goes further than most, by predicting that elimination of specifically-identified phobias will eliminate disorders of SD (PTSD, DD-NOS, DID). While there is some scientific evidence, there certainly isn't proof.