Structural Dissociation and Cores

“As an undergraduate student in psychology, I was taught that multiple personalities were a very rare and bizarre disorder. That is all that I was taught on ... It soon became apparent that what I had been taught was simply not true. Not only was I meeting people with multiplicity; these individuals entering my life were normal human beings with much to offer. They were simply people who had endured more than their share of pain in this life and were struggling to make sense of it.”

― Deborah Bray Haddock, The Dissociative Identity Disorder Sourcebook

DID Research

Structural Dissociation and Cores

 

Some individuals take the theory of structural dissociation to mean that a diagnosis of dissociative identity disorder (DID) excludes the possibility of a core or original part. This ignorance usually signals an attempt to force reality to fit theory instead of theory to fit reality. Regardless, the theory of structural dissociation does not actually have to be taken to mean that all DID systems with cores are either mistaken or actually have other specified dissociative disorder subtype 1 (OSDD-1) instead. Rather, one has to examine the theory as it exists on a spectrum to conceptualize how an early failure of integration could still allow one part to integrate before others.

 

It is clear that structural dissociation works on a spectrum. In individuals who never experience trauma or extreme stress, their personality is integrated and whole. These individuals have one complete self that can handle whatever situation it is asked to handle. Because there is only one self within these individuals, the terms "core" or "original" are irrelevant. It is only if a trauma does occur that a fracture of the self necessitates original to be differentiated from new.

 

Primary structural dissociation occurs when trauma causes an emotional part (EP) to fail to integrate with the entirety of the individual in order to preserve daily functioning. The part of the individual that was there prior to the trauma is now the apparently normal part (ANP). It may be more or less similar to the individual that it was before, but it contains all of the materials- the memories, the traits, the preferences, the emotions- that devised the individual before the trauma. Of course, this part is no longer exactly as it was before. In rejecting the traumatic materials of the EP- the memories, lessons, sensations, and emotions associated with the trauma- it narrows its own domain. In its efforts to avoid activating the EP and experiencing traumatic intrusions, the ANP experiences dissociative symptoms, amnesia, anesthesia, and emotional numbing or narrowing of its emotional range. The ANP can tire itself with these attempts at avoidance and allow for depressive symptoms, anxiety, or chronic feelings of hopelessness, guilt, shame, or rage. Regardless, the ANP still struggles to present a normal face to the world. It handles all aspects of daily life. The ANP is far more substantial than is the EP, and the goal of treatment is to allow the ANP to acknowledge, process, and reconnect with the EP. The EP handles only defensive actions such as those related to fight, flight, freeze, or submission and contains only traumatic aspects. It is not aware of the passing of time and has a very limited emotional range. It is a part that the ANP must incorporate in order to be a whole. Between the dissociated EP and the ANP struggling to continue as it had before the trauma, it is clear that the ANP is the core of individuals who are experiencing primary structural dissociation.

 

Secondary structural dissociation occurs when trauma causes multiple emotional parts, each handling different aspects of the trauma, to fail to integrate with the entirety of the individual in order to preserve its daily functioning. The part of the individual that was there prior to the trauma or that is the binding part between the EP is the apparently normal part. Secondary structural dissociation can manifest as complex-posttraumatic stress disorder (C-PTSD), borderline personality disorder (BPD), or other specified dissociative disorder subtype 1. For individuals with C-PTSD, the EP and ANP are almost identical to those of PTSD (and so primary structural dissociation) save for the number of EP and so types and complexities of intrusions. For those with BPD, the ANP likely contains far less and must attribute far more to its EP. However, the ANP of an individual with BPD is still clearly the core. Trauma or disorganized attachment for those with BPD likely began at such a young age that one cannot easily trace back to a point in which the individual had only one whole self, but it is clear that the ANP of the individual is the part that struggles to reunite all of the parts of itself into itself. The EP of an individual with BPD are childish, limited in scope, and static. EP related to attachment and detachment, to idealization and devaluation, have little in common beyond the ANP that binds them together. Were there to have been no trauma and were the attachment of the individual's childhood to have been healthy and secure, it is the ANP that would most closely match the result. The ANP would contain all that it does in this present in addition to mediated and regulated aspects of the numerous EP that it failed to integrate. It is clear that the ANP of both C-PTSD and BPD can be thought of as the core. The same is applicable to OSDD-1. Though the EP of OSDD-1 have more differentiation, they still center around one ANP (theoretically; in practice, this is one of the ways in which the theory of structural dissociation itself fails). The ANP is the adult part that must attempt to handle daily life while balancing the numerous EP that intrude. As the ANP integrates the different EP and their memories, emotions, attachment patterns, perceptions, and defensive actions, it is the ANP that becomes more whole. The EP do not work to combine with each other, though spontaneous integration may occur when dissociative barriers between two parts are no longer necessary. It is the ANP that is the central part that would have, in the absence of trauma, contained all of the aspects denied to it now. Individuals with secondary structural dissociation clearly have cores.

 

To reiterate, normally developed individuals do not have parts. They are not operating life with different self states for no valid reason. Before someone with PTSD or C-PTSD encounters a trauma, they have no separate parts. These individuals developed normally but were forced to acquire the ability to reject materials gained through a traumatic experience in order to continue to function in daily life. The ANP is the part that rejects the traumatic materials, but this ANP is at first nothing other than the whole self that was present before the trauma. As it has to reject, or dissociate from, more and more in order to avoid activating the EP and so experiencing traumatic intrusions that could be detrimental to its functioning, it narrows its own domain, but the ANP is still the part that was whole and developing before the trauma. It is the part that the EP must integrate into. It is the core and original part. In the case of disorders such as BPD and OSDD-1, it may be less clear that one part, one self, was developing before EP were dissociated, but there still remains one central part, one ANP (again, theoretically, as many with OSDD-1 actually do have more than one part that fits the definition of ANP), that is what must eventually integrate the EP in order to be whole. Cores exist in primary and secondary structural dissociation.

 

Tertiary structural dissociation is where the question of the existence of a core or original part arises. Tertiary structural dissociation, or DID (though in practicality, many cases of OSDD-1 as well and not necessarily all cases of DID), occurs when trauma causes multiple emotional parts, each handling different aspects of the trauma, as well as multiple apparently normal parts, each handling different aspects of daily life, to fail to integrate. This is only possible when trauma disrupts the natural integration of a developing child. Once one identity has been sufficiently integrated, it cannot be split and new ANP cannot be created. Many point to this as their reason to reject the presence of a core or original self in DID. They define a core as one ANP that was able to fully develop before trauma forced it to rescind its hold on one or more EP in order to continue to function. However, that is not how a core is actually defined. If one ANP began forming before trauma began or before trauma became so extreme or prevalent that one ANP could no longer adequately handle daily life on its own, this ANP would be the original part, the ANP that began forming before trauma and new experiences or expectations narrowed its domain.

 

It is impractical to assume that in no case does integration ever begin before trauma disrupts the process. Integration does not just happen when a child turns 5 or 6. It is a gradual development that begins at the time of a child's birth and continues until early adulthood. In the absence of long term or repeated trauma, integration will by ages 6-9 (depending on the child and who's doing the theorizing) naturally be sufficient so as to prevent more than one ANP from being created. After this point, additional ANP can only form in individuals who already have DID and so already have multiple ANP. What must be noted is that even though DID must form before the personality has reached this stage of sufficient integration, there is no research that suggests that it has to form before the process of integration can begin; in fact, that DID can form up until the very end of this period of integration of the self directly contradicts this idea.

 

To be clearer, contrast the cases of two theoretical children, child A and child B. Child A has been in a traumatic environment since birth, but child B’s trauma began at age 4. Both children are naturally dissociative, and neither has a support system in place to help them to handle the trauma. Both children are facing trauma that is repetitive/long term, interpersonal, and from their perspectives severe. Both children have the potential to develop DID or already fit the criteria for DID.

 

Because Child A’s trauma began at birth, child A’s personality has never had the chance to even begin to integrate one sense of self. Child A has never had parents who are willing or able to support them in integrating their disparate ego states together, and there has never been enough consistency or safety for this to be feasible anyway. Not only were multiple EP kept separate from the start in order to keep traumatic materials away from the growing self, expectations on child A itself are so inconsistent that the child couldn’t even develop one ANP. Maybe the child needs to keep one ANP as the perfect child for their mother and another ANP to avoid their father’s wrath, and neither of these ANP are suited for taking care of the child when the parents are inaccessible, meaning that as the child learns self care skills, these are automatically integrated into a third ANP. Maybe the child has to be able to without warning accommodate a parent who is at times supportive and encouraging but who can also be distant and apathetic, forcing child A to learn to use different ANP for different response patterns. In any case, for child A, no one ANP was present before the others. There were just never the right circumstances for one sense of self to form. In the case of Child A, there is no core.

 

Now consider the case of child B. Because child B's trauma began or significantly worsened at age 4, child B had 4 years before then to work on integrating one stable sense of self or one stable ANP in addition to multiple trauma-oriented EP. Child B still did not have and never has had one complete sense of self because child B is too young and hasn't yet reached that developmental stage, but progress has been made. Before the trauma began or worsened, they had either one loosely defined sense of self or one loosely defined ANP as the center of several already necessary EP. Then the trauma began or became unbearable, and suddenly, if EP were not needed before, they are now, and new EP are likely necessary even if EP had already been present.

 

From here, child B can go two ways. In the first case, they can continue with only one ANP but with multiple EP. This is a case of secondary structural dissociation and could present as C-PTSD, BPD, OSDD-1, or possibly DID if the EP were exceptionally differentiated. However, in the second case, the child is unable to continue functioning as one ANP. There could be several reasons for this. Perhaps the new trauma or sudden increase in trauma correlates with the child’s caregivers becoming erratic and unpredictable, necessitating that the child be able to rapidly switch between multiple ANP in order to fulfill contradicting expectations. Perhaps the child, as an ANP, has to be ignorant of the trauma around one caregiver but has to acknowledge it without expecting help around another. Perhaps the child is expected to perform well in school without any signs of the trauma being visible but has to be prepared to react quickly to situations at home that an EP could not handle. Perhaps the child’s new daycare center requires a loving, affection child to dull the workers’ suspicions while the child’s parents want a child who’s obedient and knows how to make themself scarce.

 

Whatever the reason, child B is now in a situation where their previously more-or-less formed ANP is no longer sufficient. Child B is still 4 and still more than capable of sectioning off materials related to their daily life to a new ANP because their sense of self never fully had the chance to integrate. They’ve never had one solid sense of self or complete self narrative simply because they’re too young. Now, new or additional trauma has made that impossible for them, and the result is additional ANP joining the self (ANP) that had already been struggling to form. 

 

Note that the defining point is that neither child A nor child B ever had one integrated sense of self at any point in time. The difference is that child A had multiple ANP forming in tangent from the beginning whereas child B had one ANP that was in the process of forming before other ANP became necessary. Child A could then be said to either have no core or to have multiple cores depending on how one views the original collection of ANP. Child B could be said to have a core in the form of the first ANP that they began to develop.

 

In either case, additional ANP have the potential to form over the course of the child's life. This is because once either child has begun reacting to new situations that they cannot handle by creating a new part for that purpose, it is likely that the child will continue to use this strategy whenever faced with new significant stressors (with what counts as "significant" depending on the child). For example, the child might create one or more new parts to handle the beginning of school, the deterioration of the child's home life, or the introduction of a new abuse or abuser. Of course, this is not a conscious creation so much as a failure to integrate relevant materials, allowing these materials to integrate amongst themselves until the resulting collection of materials is differentiated enough to count as a fragment or fully developed alter. Once a child has developed DID, the child is capable of "splitting" (failing to integrate materials or rejecting previously accepted materials that then collect as a new part) new alters at any point in time if the right conditions to necessitate the creation of a new alter are present.

 

The ability to create new alters, new ANP included, is not the only way in which systems with and without a core or original ANP are similar. In many ways, whether or not one ANP existed before other ANP could be formed is irrelevant to a system's development and presentation. The original ANP may or may not be the most well developed part. It may or may not remain the system's host, or main alter, for any significant stretch of time. After a certain point, the original ANP may fail to develop any further and may stop integrating any new experiences or materials. None of this will affect how many other ANP are formed or how developed they might become. Even if the original ANP handles most aspects of daily life and so limits the potential domains of more specialized ANP, the end result is no different than if one non-original ANP was the most dominant alter for most of the system's life. The same applies to systems who count their multiple original ANP as multiple cores. Each original ANP in turn may or may not be exceptionally well developed, be present for exceptionally long periods of time, or handle more of daily life than newer ANP, but none of these possibilities will drastically alter the system's structure or functioning.

 

DID allows for many variations, and the absence, presence, or strength of one or more core or original ANP is one such variable.

Some facts and information from the following sources:

Hart, O. (2008) Structural Dissociation of the Personality: The Key to Understanding Chronic Traumatization and Its Treatment [Powerpoint Slides]. Retrieved from European Society for Trauma and Dissociation site: http://www.estd.org/conferences/presentations/Onno%20van%20der%20Hart.pdf

Hart, O., Nijenhuis, E. R. S., & Steele, K. (2006). The haunted self: Structural dissociation and the treatment of chronic traumatization. New York: W.W. Norton.

Nijenhuis, E., Van der Hart, O., & Steele, K. (2004). Trauma-related structural dissociation of the personality. Retrieved from http://www.trauma-pages.com/a/nijenhuis-2004.php