Information and misconceptions on CDDS
Levels of Structural Dissociation
Exploring the theory of structural dissociation from its origins to current understanding.
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Table of Contents
1. Overview - What is Structural Dissociation?
2. Formation of and Types of Parts
3. Primary Structural Dissociation
4. Secondary Structural Dissociation
5. Tertiary Structural Dissociation
6. Non-Structural Dissociative Disorders
7. Sources and Further ReadingIf you came from the non-structural dissociation carrd, 6 will take you back. If you started here, 6 takes you to a separate carrd with further information on dissociative disorders.
What is Structural Dissociation?
The Haunted Self published in 2000 by Onno van der Hart et al outlines the theory of structural dissociation of the personality. Under this theory, complex dissociative disorders (CDDs) are caused by trauma at an early age, prior to the integration (coming together) of the personality. Throughout this resource I will refer to personality and identity interchangeably, as this is how “personality” is used in the context of dissociative disorders.In the case of early childhood abuse or neglect, (accounting for development of the majority of CDDs) “parents of disorganized infants may engage in frightened or frightening interactions with their children, thereby presenting the infant with the paradox that the parent is a source of threat and a source of protection… during times of stress when the attachment system is activated, contradictory internal working models of self and other may become evident.”Essentially, abusive (see: “frightening”) and disorganized behaviors towards children cause them to develop an unstable sense of self, as they learn from their primary caregivers that people as a whole are unstable entities. However, direct abuse is not the only cause of these paradoxical traits, as intergenerational (passed down through a family) instability can lead to these “frightened” interactions, as opposed to the directly “frightening” interactions. In short: a parent who themself is mentally disordered or suffered trauma may not know how to adequately provide secure attachment to their child, even without directly abusive behavior. This, combined with repetitive non-abusive traumatic incidences, such as exposure to violence outside of the home or stress related to a singular event with reverberating consequences, may lead a child to form a CDD without direct abuse from a parental figure.
Formation of and Types of Parts
This “unstable sense of self” formed in early childhood is known as identity incongruence, and is observed in CDDs as an outcome of dissociation and compartmentalization of the self into parts (see my other carrd on emotional compartmentalization).Parts are seen across the dissociative continuum (spectrum) from cPTSD where there are usually only two, to polyfragmented DID where there can be up to thousands. Parts can be broadly classified into two types, ANPs and EPs, however, a third type can also be further specified, which are MPs. Further, parts can be either elaborated (developed) or fragments (undeveloped).
ANP: Apparently Normal Part
There must always be the presence of a single “apparently normal part” in any CDD. This ANP is the part that carries on with normal day-to-day life, and may not know about any trauma the self has experienced, or may feel unaffected by their trauma. ANPs may present with indifference towards known traumas, feeling the same as if it had happened to somebody else entirely. Similarly, ANPs may present with some distress at knowing the trauma exists, yet still seem inappropriately disconnected from it. An ANP presents with negative symptoms of PTSD.ANPs are very convincingly a whole and complete person to the outside world. However, ANPs have an inappropriate lack of connection to their memories (be it total amnesia or emotional indifference) which is crucial to their emotional dysfunction as “apparently” normal parts.
EP: emotional part
In order to have a CDD, there will always be at least one “emotional part” in the disordered individual. EPs exist to hold trauma and the emotions that are associated with it, and do not typically face day-to-day life. EPs are very aware of their trauma, and they may feel overwhelmed by it. However, EPs are much better equipped to deal with new stressors and traumatic situation. They are built to cope and protect. An EP experiences positive symptoms of PTSD.EPs may be able to present as a full individual for short periods of time, but under scrutiny, often lack a full range of emotional display, personality traits, or interests. This is not to have EPs confused for fragments, but to acknowledge that even their fully elaborated form is not as detailed as an ANP or MP.
MP: Mixed Part
Only CDDs with tertiary dissociation can present with “mixed parts,” and not all cases of tertiary dissociation will have them. MPs are parts which have features of both ANPs and EPs. They may remember some trauma or only specific types of trauma, and not remember others or be indifferent to them. An MP may experience either or both positive and negative symptoms of PTSD.MPs are often able to present as full individuals, with both coping mechanisms for stressors and a range of personality.
Elaborated Parts and Fragments
As CDDs get more complex, the presence of fragment parts grows stronger. While fragments will not be present at all in most simpler cases of structural dissociation, complex structural dissociation will have many of them.
Fragments are very small parts which serve hyperspecific functions, hold only few memories, or hold single emotions. These parts could not present as a full individual on their own outside of their specific purpose, as that is all they were built to do.Elaborated parts, on the other hand, are the opposite. They serve broad and general functions, hold many or even most of their memories, and have access to most of their emotions. Their ability to present as a full individual may be partially limited, but even EPs have a much broader range of scenarios they can function in.
Primary Structural Dissociation
Primary structural dissociation is defined by the presence of one ANP and one EP. This is the type of dissociation present in some cases of PTSD and OSDD-1, and in most cases of cPTSD.In primary structural dissociation, the ANP and EP have very little if any difference in identity between them, although their emotional states will differ greatly. Outside observers may feel that the individual appears “off” or “moody” when experiencing dissociation between one part and the other.The ANP handles the vast majority of day-to-day life, and it is only taken over by the EP when experiencing a trigger or significant stressor, bringing about overwhelming feelings of dissociation. This can lead to the individual appearing “spaced out” during important conversations or seeming disinterested in activities.
Secondary Structural Dissociation
Secondary structural dissociation is defined by the presence of one ANP and multiple EPs. This is the type of dissociation present in most cases of OSDD-1 and BPD, and in some cases of cPTSD and (p)DID. OSDD-2 may also be included in this category, however, I cannot consider myself educated enough on OSDD-2 to discuss in depth its nature.In secondary dissociation, the ANP and EPs may present with little to no identity differences, or with marked identity differences.cPTSD with multiple EPs presents similarly to cPTSD with one, just that the EPs may be more specialized to different situations. In this case, EPs will not present with a different identity from the ANP.Secondary structural dissociation is most relevant to OSDD-1, wherein most cases feature it. In this case, switches between parts are primarily related to triggers and stressors, however, there may be EPs which exist for specific alter “roles,” fulfilled during situations requiring them. Examples of these roles include a fragment for visiting a doctor’s office or an internal self helper that assists other parts with day-to-day tasks.
Cluster B personality disorders
BPD (borderline personality disorder) is officially recognized as integrated secondary structural dissociation. This means that between the ANP and EPs, very little memory is lost. In times of emotional dysregulation, those with BPD often experience heightened levels of non-dissociative emotional amnesia. EPs in BPD are commonly referred to as facets, although the more common medical term is scheme mode. There are several broadly recognized schema modes, often fulfilling very stereotypical roles such as “innocent child” and “workplace adult.” In personalized treatment, schema modes often receive more tailored roles and even names for the client.This next section relies on less certain research, so it should be taken with that in mind.There have been studies on all cluster B personality disorders suggesting greater levels of dissociation, and this is natural for their co-occurrence with cPTSD, however, ASPD and NPD in particular suggest integrated secondary structural dissociation, much in the same way as BPD.In ASPD, schema modes can be observed, and they are observably triggered out through stressful scenarios, and as a response to extreme emotional states (primarily anger). These schema modes serve similar purposes as in BPD, even sharing the same role names, though different roles are observed with greater frequency in ASPD, such as the “bully” schema.In NPD, out-of-body dissociation is observed, and the individual appears to have inner-council with their parts. These parts are primarily introjected from the individual’s peers, with whom there is internal competition. There is observed division between the individual’s multiple senses of self, compartmentalizing their ideal traits and most negative traits into two “halves,”which they may present under varying circumstances of stress or (perceived) failure.
Tertiary Structural Dissociation
Tertiary structural dissociation is defined by the presence of multiple ANPs and multiple EPs, as well as the possible presence of MPs. This is the type of dissociation present in most cases of (p)DID, and is present in some cases of OSDD-1. Although The Haunted Self originally considered that DDNOS-1 was always a disorder formed with secondary structural dissociation, it is now understood that many tertiary cases still fit OSDD-1 diagnostic criteria.In tertiary dissociation, differences in identity between both the ANPs and the EPs will be observed, although the differences can be minor.Unlike the past two levels, triggers and stressors are not the main reason for switches between parts. Parts may commonly switch for day-to-day functions simply as an extension of their roles, fulfilling tasks such as going to school or work, or engaging with specific relationships. Systems may present with multiple parts fronting (conscious) together at once, able to communicate with one another, ultimately working together to get through the day. This is more commonly seen in polyfragmented systems.Just as BPD was discussed earlier for its atypical presentation of secondary structural dissociation, so too must pDID be mentioned for its interaction with tertiary dissociation. While pDID can, much like typical DID, feature either secondary or tertiary dissociation, the manner of switching and fronting between parts is different from typical cases of DID and OSDD-1. pDID was originally described as “subthreshold DID.” In pDID, one part—known as the “dominant part”—is (nearly) always present. Identity disturbances are created by the influence of other parts maintaining co-consciousness with the dominant part. pDID systems can experience rare cases of a full switch, but otherwise are defined by their lack of full switches. Regardless of amnesia or amnesia types, partial DID is always diagnosed with “DID” and not “OSDD.” While pDID can present similarly to BPD, and some studies suggest they are closer on the continuum than typical OSDDID with BPD, they are classified as different disorders and feature different symptoms with overlap primarily existing in the dissociation pattern.Tertiary dissociation also sees a unique feature known as “subsystems,” which are groupings of parts together in certain ways. These groups can present as parts with close communication or a part with its own parts.Although polyfragmentation is not its own disorder, the dissociation within polyfragmented DID or OSDD-1 is more even complex than in other cases of tertiary dissociation, and features large part counts (especially fragments), multiple subsystems, formation of new parts under a low stress threshold, and the exclusive feature of further grouping of parts into “layers,” which are unable to access each other without specific other parts or integrative therapy.
Sources Used
The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization.Dissociative disorders are real and traumagenic in nature, and iatrogenesis is demonstrably false.Disorganized attachment in childhood leads to dissociation in adulthood.DID or OSDD: Does it Matter?Structural dissociation in BPD, disorganized attachment.On the lack of acknowledgment of structural dissociation in cPTSD.OSDD-1 can be polyfragmented and tertiary. TW for RA topics and themes.Integration and fragmentation in DID.DID Fact and Fiction: dispelling misconceptions.BPD facets as a form of partial DID.ASPD presents with schema modes.Dissociative response to emotional dysregulation and stressors in ASPD.Betrayal trauma and ASPD development.NPD with pathological dissociation: introjection, division, and internal communication.Dissociation and Self-Perception in NPD.DID as a spectrum disorder: partial DID and OSDD-1 explored.