Distinct states

Distinct states are parts of the personality systemAll states that make up the personality in an individual., which stem from from structural dissociation due to a build up of unprocessed trauma events, that when an individual is overwhelmed, causes a "split", separating the personality into a distinct state and a less than distinct state. ^[1] At no other time is the term split accurate. It is a one time thing that is caused by the first build up of unprocessed trauma events that overwhelms an individual. The following mental disorders are the results of structural dissociation of the personality: posttraumatic stress disorder (PTSD), other specified dissociative disorder (OSDD), and dissociative identity disorder (DIDDissociative identity disorder is a disorder of mental states, where a individual switches from one distinct state to another distinct state, which distinguished it from OSDD/DDNOS, BPD and PTSD. {{Rp|557-570,487-494,471-486}} {{See also| Dissociative Identity Disorder}}) structural dissociation can take place in and in borderline personality disorder (BPD), but not until after the mental disorderThe DSM-5 psychiatric manual defines this as "a syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. An expected or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above."{{Rp|20}} exists, so it does not cause the disorder. Acute stress disorder (ASD) and simple Dissociative Disorders were at least thought to be included as mental disorders caused by structural dissociation at one time, and might still be, but they have not been in recent literature. ^{[2] [1]}

Brief history and where we are today

The first person to report that he had observed individuals with parts that appear to be "normal" and other parts that are "emotionally distressed" was Charles Samuel Myers, (born March 13 1873, London and died October, 12 1946, Winsford in Somersetshire), who used the term "apparently normal part" to describe a distinct state, and that term is probably still the most accurate term used today. ^[2] Pierre Marie Félix Janet, (born May 30, 1859, Paris, France and died February 24, 1947, Paris) is given credit for the intellectual thought that went into great depths beyond the work that Myers did. Janet developed a theory that was ignored by the vast majority of the world, that sadly is just now gaining world-wide acceptance. ^[2] A couple of today's top researchers have exhumed the teaching of Janet and have added modern neurology, physiology, biology and intellectual reasoning. These two men, along with Kathy Steele, developed a modern day theory, and in 2006 wrote the , which described in detail what a distinct state is. ^[2] They used the term provided by Charles Samuel Myers, which is "apparently normal part" (ANPA distinct state who performs the job of daily activities and does not hold trauma memories. Dissociative identity disorder is the only mental disorder where an individual can have two or more ANP. {{See also| structural dissociation}}). ^[2] More recently other researchers, who may not use the term "apparently normal part" (ANP), do understand and support the proposal and concept, but use the term distinct state or something similar. Many concepts presented in the have been advanced beyond the authors primary work submitted in 2006. They and other researchers have now added to the theory of structural dissociation of the personality. ^[3]:243-493 In addition, neurologists, biologists and other scientists doing their own research, have come to the same conclusions that Nijenhuis, van der Hart and Steele proposed in their landmark book. ^[2]

Distinct state in posttraumatic stress disorder (PTSD)

In the , the authors Onno van der Hart, Ellert Nijenhuis (pronounced Nee-An-Hoff), and Kathy Steele have described the one distinct state found in posttraumatic stress disorder as a part that engulfs the majority of the personalityEvery individual has a personality that is composed of many diverse, fragmentary and generally illusory images of [[Personality|self]]. (see multiples) The DSM-IV uses the term identity in its definition of dissociation. (see identity) {{Rp|127}}. ^[2] That of course leaves the rest of the rest of the personality to hold the unprocessed trauma events and in doing so, those parts called, less than distinct states, are the ones that react to the unprocessed trauma events in many ways including flashbacks, hypervigilance"Excessive attention to and focus on all internal and external stimuli."{{Rp|26} A pattern presenting with fight or flight reactions is common in individuals with unprocessed trauma memories. {{Rp|217}} A PTSD symptom. Hypervigilance is an arousal symptom within PTSD and acute stress disorder."Excessive attention to and focus on all internal and external stimuli."{{Rp|26} A pattern presenting with fight or flight reactions is common in individuals with unprocessed trauma memories. {{Rp|217}} A PTSD symptom. Hypervigilance is an arousal symptom within PTSD and acute stress disorder., and hypovigilance. ^{[2] [1]}

In the image to the right, an fMRIA type of neuroimaging. Neuroimaging is an approach that allows researchers to view areas of the brain that become active during behavioral events such as emotion, perception and cognition. It is part of the science of in psychophysiology. scan shows a distinct state in the process of switchingFull dissociation is when an alter switches with the alter currently in executive control, resulting in amnesia for that alter. (see executive control) {{Rp|4-6}} In full dissociation, there is complete amnesia between dissociated states, which is a {{Rp|228}} criteria for a diagnosis of dissociative identity disorder in the DSM-5. {{See also| Dissociation}} with an other distinct state, which is only possible in DID. The left image shows the type of state that attempts to manage "unprocessed trauma events" that are "stuck in the mind", and have yet to be moved to the hippocampus of the brainThe brain is a approximately a 1300-gram organ containing 100-billion neurons. It is the control center of the central nervous system. The mind and brain are not the same thing. (see mind) The mind emerges out of interactions between the brain and relationships during the earliest years of childhood. Different child-parent attachment relationships form differing physiological responses, patterns for interpersonal relationship and how an individual views the world. {{Rp|9}} (see attachment) for memory processing. In OSDD fMRI scans reveal only one distinct state if possible, and it switches with less than distinct states randomly and also in response to a "triggerA reactivating stimulus in trauma disorders. A stimulus in the present which is a reminder of a part of a traumatic [[memory]], which can cause the part of an individual that hold the trauma (EP) to feel as if it is reliving past trauma experience. {{Rp|166-186}} Also known as a trauma trigger.." In contrast to DID, every single state can literally be lit up (conscious) at one time. In response to a trigger however, all but one state will leave consciousness. In PTSD there is only less than distinct state and distinct state, and both stay lit until a trigger causes the less than distinct state to respond. It does so in several ways, but a flashbackA flashback is a reactivated traumatic memory experienced as intrusive thoughts, feelings, or images associated with past trauma, but lacking a sense of being from the past. {{Rp|30}} It is experienced by the state referred to as the EP. {{See also | Grounding techniques}} is probably the best known. As the less than distinct state responds the distinct state leaves consciousness. In the complex version of PTSD there are always two less than distinct states, and one distinct state. The less than distinct states stay together, with both always in consciousness at the same time. BPD involves one distinct state and it's always visible until the individual is in distress, and then two less than distinct states show up together, but unlike C-PTSD these less than distinct states do not take over consciousness. The distinct state always remains with them. There are no flashbacks or other symptoms caused from unprocessed trauma events in BPD, but there are other dissociative symptoms. ^{[4] [2]}

Distinct state in the complex version of posttraumatic stress disorder (C-PTSD)

In what is referred to as complex-posttraumatic stress disorder there is one distinct state and two less than distinct states, but the distinct states combined do not seem to hold any more "capacity" than what is seen in the simpler version of posttraumatic stress disorder. ^[1]

Distinct state in other specified dissociative disorder (OSDD)

Other specified dissociative disorder is one of the two complex Dissociative Disorders and the distinct states in these disorders are very different from what is seen in any other version of a disorder that is caused from or has symptoms from structural dissociation. ^[2] In other specified dissociative disorder there will be one distinct state and two or more less than distinct states, and the distinct state will have the unique quality of being able to act as a "frontA term sometimes used by those with dissociative identity disorder to refer to the alter who is either in executive control of the individual, or who has come close to the one that is in executive control. (see executive control)." It's typical that the distinct state in this disorder is the state that is "out" most often, but it switches rapidly when the less than distinct states are triggeredA reactivating stimulus in trauma disorders. A stimulus in the present which is a reminder of a part of a traumatic [[memory]], which can cause the part of an individual that hold the trauma (EP) to feel as if it is reliving past trauma experience. {{Rp|166-186}} Also known as a trauma trigger.. ^[2] When triggered, either the whole less than distinct state takes over, or the emotions from that state influence the distinct state through passive dissociation. ^[2] People with this disorder are highly triggered, unlike those with dissociative identity disorder. ^[2] Individuals with dissociative identity disorder are very different in their response to a trigger. ^[2] All humans have access to their inner worldInner reality in dissociative identity disorder (Closed System). In this disorder each dissociated state has its own inner reality, while at the same time there is a common inner reality where states have a distinct, phantom appearance. {{Rp|301}} A closed system is a self care system that helps a child manage [[Attachment disorder|traumatic attachments]], and provide as a supplement to the scarce supplies available in an abused child's interpersonal environment. {{Rp|71}}, but those with this disorder experience it in a more vivid way. ^[5]

Distinct states in dissociative identify disorder

Dissociative identity disorder is the only mental disorder with two or more distinct states. ^{[3] [2]} The states are highly different from any disorder discussed so far on this page. ^{[2] [1]} These states are ruled, literally, by phobia of the other distinct states, which is what makes this disorder easily identifiable from other specified dissociative disorder. ^{[2] [1]} In dissociative identity disorder the affects of the dissociative boundaries around the distinct states literally encapsulate these states. ^[3]:243-493 The dissociative boundaries keep the states from experiencing the effects of the other states, both distinct and less than distinct, which exist in the individual's personality system. ^[3]:243-493 This is why an individual with dissociative identity disorder would rarely ever complain about "triggers". ^[3]:243-493 They are not highly affected by them, unlike individuals with other specified dissociative disorder who are highly sensitive to triggers. ^[3]:243-493 The mental disorder, dissociative identity disorder will always have, as a minimum, two distinct states and two less than distinct states. ^[2] The amnesia requirement in the DSM-5 is identified when a switch is made between two distinct states. ^[2] Distinct states are the parts of the personality that attend to daily life activities, and so what would be seen is a state switch between two states that attend to daily life activities. ^{[2] [3]:243-493} It's very unlikely this switch would ever involve a child-like state. ^[3]:243-493

Distinct states in this disorder have two ways of being; one realm is the inner world and the other is the face of the individual. The inner world is directed by innate and primal fear which divides states and keeps them at arms length, so to say. ^[3]:243-493 Once fear is reduced to an "acceptable level" then "memory"Memory is not a static thing, but an active set of processes." {{Rp|51}} "Our earliest experiences shape not only what we remember, but also how we remember and how we shape the narrative of our lives. Memory can be seen as the way the mind encodes elements of experience into various forms of representation. As a child develops, the mind begins to create a sense of continuity across time, linking past experiences with present perceptions and anticipations of the future." {{Rp|11}} sharing" can take place. ^[3]:243-493 In the inner world there are both distinct and "less than distinct states," and each state is fearful to one extent or the other. This fear directs their very behavior and shapes who they are. Communication comes first, followed by memory sharing and finally "unification," which is the normal way the personality presents after a "safe" childhood. ^[2]

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Other branches of the Trauma and DissociationDissociation is a compartmentalization of experience, where elements of a trauma are not integrated into a unified sense of the self. {{Rp|4-810, 127}}The lay persons idea of [[dissociation]], that which exists in the normal mind, is not what is referred to in this document. {{Rp|233-234}} Project

Dissociative Identity Disorder.org is a multi-authored peer written site, reviewed by a health care professional.

References

1. ^ a b c d e f Nijenhuis, Ellert R. S.; van der Hart, Onno (2011b). Defining Dissociation in Trauma. Trauma & Dissociation, volume 12, issue 4, page 469-473. (doi:10.1080/152999)
2. ^ a b c d e f g h i j k l m n o p q r s t u Vanderhart, Onno (2006) (coauthors: Nijenhuis, Ellert; Steele, Kathy). . New York:Norton. 13: 978-0393704013.
3. ^ a b c d e f g h i j Lanius, Ulrich (2014) (coauthors: Sandra L. Paulsen, Frank M. Corrigan). . New York:Springer Publishing Company. 10: 0826106315.
4. ^ Schlumpf, YR; Reinders, AATS, Nijenhuis, ERS, Luechinger, R, van Osch, MJP, et al. (2014). Dissociative Part-Dependent Resting-State Activity in Dissociative Identity Disorder: A Controlled fMRI Perfusion Study. PLoS ONE, volume 9, issue 6, 2014. (doi:10.1371/journal.pone.0098795)
5. ^ Siegel, Daniel (2012). . Guilford press. 13: 978-1462503902.