Reddit reviews Dissociation and the Dissociative Disorders: DSM-V and Beyond

That's interesting to me, you know why my amnesia causes so much stress it make me feel crazy, out of control, weak, scared. It's not fun. I've taken dozens of pills in a suicide attempt, I've assaulted people, and/or threatened to kill them, lost jobs, deleted social media, slept with random people, things disappear, and I have been called a liar because I dissociate my actions for my entire life.


I read an r/CPTSD thread one time about if anyone else wished they had cancer because it would concretely validate their pain, it would be something they could physically point to and say see, "I did have it rough." To me this reads like that. I've had cancer twice those people were nuts for asking for it.


Do you know why Amnesia is such a disconcerting thing, because it messes with our continuity of experience, which in turn leaves us fully unable to synthesize or realize said experience? Let's take a look at some things, I like perceptual theory as a lens here for how we experience the world.


> Alter personalities are complex; they probably do not develop from a single trauma or without substantial preparatory experience and psychological mediation. Derealization, on the other hand, is a less complex psychological process; this alteration in how the world is perceived is a more immediate response to current sensory input. These two observations about alters and derealization reflect the fact that dissociation is characterized by two quite different phenomena: (1) alters and (2) perceptual alterations. Based on his perceptual theory of dissociation, Beere (1995) asserted that the creation of an alter identity is an order of phenomenon different from dissociative perceptual experience (though, in the process of living, these two phenomena often occur together). Amnesia is a third type of dissociative phenomenon that stands on its own (as well as being strongly linked to alter identities). In short, the domain of dissociation has three conceptual foci: dissociative perception, alters, and amnesia. This chapter will present a theoretical explanation of these phenomena: the fi rst theoretical explanation pertains to dissociative perception; the second has to do with the functioning of the self-system and how that leads to depersonalization, amnesia, and alter identities in fugue and Dissociative Identity Disorder (DID).

18.1 DISSOCIATIVE PERCEPTION

Beere’s (1995) perceptual theory of dissociation asserts that dissociative perception stems from a blocking-out of the perceptual background. Experience generally presents itself whole, but it has the following structure: (1) I, (2) having this mind, (3) in this body, (4) in this world, (5) all of which are in time, perceive this figure in this ground (Figure 18.1). These five components comprise the background framework for all perceptual experience; each of us takes this figure-ground-background organization of perceptual experience for granted. The term background defines these five ever-present components of the perceptual framework. Everyday experience involves a constant flow of different figure/ground perceptions; time, world, body, mind, and identity usually reside in the background. During dissociation, however, the background is lost or loses its constancy. Because the lived-integration of figure-ground-background constitutes meaningful lived-experience, the rupture of this lived-integration makes dissociative experience weird, bizarre, or uncanny. All of these aspects of experience—identity, the world, and its constituents (i.e., inanimate objects and living beings), my body, my mind, even the experience of time—are created in consciousness, from consciousness, and through consciousness (Merleau-Ponty, 1962). To emphasize this point, my identity—who I am—is not created by me. Rather, I, as I know myself, am the creation of consciousness. Two alternative perspectives might be helpful in clarifying these ideas. Harry Stack Sullivan’s (1956) self-system approximates the creation of self in consciousness because the self-system creates the “I,” the “other,” and the relationship between them. Alternatively, from a neuropsychological perspective, everything we experience must be “created” in the brain. All neurological input must be integrated into the various particulars we experience, whether external objects, our bodies, our minds, or our identities. In a situation that leads to dissociative perception, the individual blocks out the background by focusing solely on one critical aspect of the situation. That aspect is of such importance that perception focuses on it exclusively— and blocks out the background. Those blocked inputs from the background become dissociative perceptual experiences.



I'm gonna leave you with Kulft's words here as well about how elaboration and distinction of parts are an epiphenomenon.

> So, how can clinicians discern the presence of alter personalities? What do alter personalities look like? The best answers to these questions can be found in Kluft’s (1985b) superb clinical description of MPD: “The natural history of multiple personality disorder.” This 20-year-old clinical-descriptive essay is still the single best account of the appearance and behavior of alter personalities. Upon re-reading this remarkable piece of clinical-descriptive psychiatry, we (re)discover two basic facts about MPD. First, although the DSM requires the presence of distinct personalities, naturally occurring DID does not. Quite the contrary. DID is a defensive adaptation that protects the person from a chronically dangerous environment. DID’s first priority is defense—not the conspicuous display of distinct personalities:
The raison d’être of multiple personality disorder is to provide a structured dissociative defense against overwhelming traumata. The emitted observable manifestations of multiple personality disorder are epiphenomena and tools of the defensive purpose. In terms of the patient’s needs, the personalities need only be as distinct, public, and elaborate as becomes necessary in the handling of stressful situations. (Kluft, 1985b, p. 231) In fact, most multiples self-protectively hide their multiplicity from others (Kluft, 1985b). Second, visible switches from one distinct personality to another are infrequent: “visible switching from one alter to another probably ranks among the least frequent phenomena of DID” (Dell, 2009a). In short, “overtness is not a basic ingredient of MPD” (Kluft, 1985a, p. 6)—even if the DSM implies that it is (or that it should be). Remember, the DSM requires overt DID; if the clinician cannot discern the presence of two or more distinct identities who switch (i.e., overt DID), then the patient cannot receive a diagnosis of DID. Now, obviously, many cases of DID have been successfully diagnosed on the basis of the “distinct personalities” The problem is that these factors pertain to a small minority of MPD patients at the sicker end of the scale or during episodic decompensations. The overwhelming majority of MPD patients do not manifest “distinct personalities” (or, they do so very infrequently). I do not believe that it is possible to operationalize the “distinct personalities” criterion in a way that will allow
clinicians to successfully diagnose those MPD patients who are currently undetectable according to the “distinct personalities” criterion).




My source for the day is:
https://www.amazon.com/Dissociation-Dissociative-Disorders-DSM-V-Beyond/dp/0415957850

Edit, I see you edited your comment, while I was replying to say you didn't want trauma to spread, if those parts are trying to communicate their experience you should listen, they won't stop because you don't want to hear.