#cdd research

[sysmedsaresexist]

Since my reply is hidden, I've decided to just make my own post about this and put some accurate info out there.

Covert DID vs Overt DID & Possession vs Non-possession: They don't mean what you think they mean!

Here's a bunch of facts and info in no particular order!

I saw a post about how masking isn't a type of covert DID, and I'm here to tell you that

Masking was the original covert!

Dissociation and the Dissociative Disorders (by Dorahy, Gold & O'Neil, 2nd edition, 2023)

You know the statistic in the DSM about covert/overt systems? It's taken from Kluft, above. And it includes masking.

Covert and overt aren't actually used all that often clinically, but it actually has several meanings, INCLUDING MASKING. Neither has to do with possession or non-possession, but they're unfortunately often incorrectly equated as "possession form = overt" and "non-possession = covert". They can overlap, but this is incorrect!

Possession's biggest use is for a disorder that no longer exists as a separate entry in the DSM 5.

Possession-Trance disorder still exists in the ICD, though, and we'll start there.

Trance disorder

"The trance state is not characterised by the experience of being replaced by an alternate identity."

"Trance Disorder is characterized by recurrent or single and prolonged involuntary marked alteration in an individual’s state of consciousness involving a trance state (without possession)."

"The trance state is not characterized by the experience of being replaced by an alternate identity."

"The identities of the possessing agents typically correspond to figures from the religious traditions in the society."

"In Possession Trance Disorder, the individual’s normal sense of personal identity is experienced as being replaced by an external ‘possessing’ spirit, power, deity or other spiritual entity, which is not the case in Trance Disorder. Possession trance states often include more complex activities (e.g., coherent conversations, characteristic gestures, facial expressions, specific verbalizations) than are typical of trance states, which tend to involve less complex activities (e.g., staring, falling)."

We can already see how this is starting to play out with overt/covert and non-possession/possession form.

Possession trance disorder

"Possession trance disorder is characterised by trance states in which there is a marked alteration in the individual’s state of consciousness and the individual’s customary sense of personal identity is replaced by an external ‘possessing’ identity and in which the individual’s behaviours or movements are experienced as being controlled by the possessing agent."

"Trance episodes are attributed to the influence of an external ‘possessing’ spirit, power, deity or other spiritual entity."

"During possession trance states, the activities performed are often relatively complex (e.g., coherent conversations, characteristic gestures, facial expressions, specific verbalizations that are frequently culturally accepted as belonging to a particular possessing agent)."

"Presumed possessing agents in Possession Trance Disorder are usually spiritual in nature (e.g., spirits of the dead, gods, demons, or other spiritual entities) and are often experienced as making demands or expressing animosity."

"The identities of the possessing agents typically correspond to figures from the religious traditions in the society."

"This is distinguished from Dissociative Identity Disorder and Partial Dissociative Identity Disorder, which are characterized by the experience of two or more distinct, alternate personality states that are not attributed to an external possessing agent. Individuals describing both internally and externally attributed alternate identities should receive a diagnosis of Dissociative Identity Disorder or Partial Dissociative Identity Disorder. In this situation, an additional diagnosis of Possession Trance Disorder should not be assigned."

From Dissociative Identity Disorder, I only want to note one thing:

"Individuals who describe both internal distinct personality states that assume executive control as well as episodes of being controlled by an external possessing identity should receive a diagnosis of Dissociative Identity Disorder rather than Possession Trance Disorder."

So, already, we've learned that possession and non-possession have to do with whether the entities are experienced as internal or external agents.

You'll note that the ICD doesn't mention covert or overt at all.

So back to the DSM-- “possession” was diagnosed as Atypical Dissociative Disorder in the DSM-III or DDNOS in DSM-III-R. In DSM-IV, possession and trance were diagnosed as sub-categories of the Dissociative Trance Disorder (DTD), and in DSM-IV-TR they were merged into one, and recognized as a cultural variant of the Dissociative Disorder Not Otherwise Specified [DDNOS]. In DSM-5, possession-form presentations are linked with criterion A of DID: “Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession” (p. 292).

Another common myth has to do with amnesia and covert/overt. The facts are:

Covert DID is associated with the highest levels of blackout amnesia. That's how it stays covert. People have amnesia for their own amnesia. It's an incredible phenomenon that's highly documented.

Overt DID typically has the same or less amnesia. It's much harder to explain away noticeable behaviour so people are much more aware of their own gaps in memory and can begin treatment sooner. They're much more easily diagnosed. As internal dialogue and intrusion are far more different in these entities, people become aware sooner and experience more grey out amnesia thanks to this basic awareness.

Covert DID is no longer diagnosed as OSDD 1a. The DSM 5 introduced new reporting criteria that allow the patient and their family to self report switches. OSDD and DDNOS 1a were primarily used for situations where the clinician didn't witness a switch during interviewing. As such, OSDD these days mainly covers P-DID presentations where switching is genuinely rare, if it happens at all. While P-DID is less associated with amnesia, OSDD 1a will require it. P-DID without amnesia will fall into 1b or DID itself, thanks to the DSM's updated amnesia wording.

For this next bit, I'll be using the DSM 5, as that's what I have in front of me, for the purposes of this conversation, this version will do fine.

"Dissociative identity disorder is characterized by a) the presence of two or more distinct personality states or an experience of possession."

"The fragmentation of identity may vary with culture (e.g., possession-form presentations) and circumstance. Thus, individuals may experience discontinuities in identity and memory that may not be immediately evident to others or are obscured by attempts to hide dysfunction."

You know, overt/covert, and wow, it doesn't just have to do with the entities, BUT HOW YOU DESCRIBE YOUR DISORDER?!

You mean... like masking?

Holy shit, yeah, the DSM just said that.

These terms are not as interchangeable as some people think they are. They have very unique meanings and are very different concepts, not only from each other, but from how they're often used within the community.

To reiterate:

Possession form = external entities

Non-possession = internal entities

Overt = noticeable behaviour and mannerisms

Covert = hidden or sneaky behaviour or mannerisms

These can and do overlap, but exist as separate concepts.

More from the DSM:

"The defining feature of dissociative identity disorder is the presence of two or more distinct personality states or an experience of possession (Criterion A). The overtness or covertness of these personality states, however, varies as a function of psychological motivation, current level of stress, culture, internal conflicts and dynamics, and emotional resilience."

Oh, wow, it changes over time and can vary between alters themselves?! Wow.

"Sustained periods of identity disruption may occur when psychosocial pressures are severe and/or prolonged. In many possession-form cases of dissociative identity disorder, and in a small proportion of non-possession-form cases, manifestations of alternate identities are highly overt. Most individuals with non-possession-form dissociative identity disorder do not overtly display their discontinuity of identity for long periods of time; only a small minority present to clinical attention with observable alternation of identities."

"Possession-form identities in dissociative identity disorder typically manifest as behaviors that appear as if a “spirit,” supernatural being, or outside person has taken control, such that the individual begins speaking or acting in a distinctly different manner. For example, an individual’s behavior may give the appearance that her identity has been replaced by the “ghost” of a girl who committed suicide in the same community years before, speaking and acting as though she were still alive. Or an individual may be “taken over” by a demon or deity, resulting in profound impairment, and demanding that the individual or a relative be punished for a past act, followed by more subtle periods of identity alteration."

So, yes, according to the DSM, purposefully masking is a covert presentation, and it has nothing to do with possession or non-possession form. The way a system "naturally" presents will change many times over the course of their disorder.

IN FACT, if we want to get technical, covert actually refers specifically to heavy fragmentation in most clinical texts. Fragments are typically experienced internally and as intrusion, rather than switches. Here's a source.

Covert DID is a less dramatic and more subtle form of the disorder. In this variant, individuals with DID do not display overt switches or distinct personalities. Instead, they experience a fragmentation of their identity, leading to a lack of continuity in their sense of self and memory. These individuals may not even be aware of their condition and might attribute their memory lapses and identity shifts to stress, forgetfulness, or other factors.

Covert DID can be challenging to diagnose because the symptoms are less obvious. It often goes unrecognized for years, and individuals may suffer in silence without understanding the source of their difficulties. Therapy and expert evaluation are essential for identifying and addressing covert DID.

And another.

In addition, diagnostic challenges can result from identity alteration or personality switching not as obvious as expected. In fact, many patients have “covert DID” or “OSDD,” which is characterized by partial dissociation (e.g., dissociative intrusions) rather than full dissociation (i.e., switching plus amnesia).

In the end, though, these terms aren't used all that often, and various uses will still be understood in a clinical setting. Doctors can't even agree on definitions, so use them however you want.

It's not that big of a deal.

I hope this post was useful, even if it was a bit disjointed.

[light-alexandria]

hello, system community!

i’m trying to find information/hear personal experiences of systemhood from others, if any of you would be so kind as to help me!

particularly, i would like to hear from those who identify as endogenic or otherwise non-trauma formed systems. of course, i would love to hear from trauma-formed systems as well! it’s just that i am one, and so that’s the community i have been most involved with & heard from already.

feel free to DM me anonymously if you don’t want to share publicly. i won’t post anything. my aim is to hear from others so that i can form my own opinions, figure out the right direction to go for independent research, and to simply understand others more.

thank you very much in advance, and i hope you all are having a wonderful day 💙

(please be mindful & respectful with what is said if you reply publicly. i am looking for open discussion, not arguments or hate.)

[the-astrophel-system]

pro endos and endos, this is your one post that you can interact with. dm, comment, reblog, ask, whatever.

send me links, send me proof. send me studies and research and actual readable things explaining how non traumatic plurality is possible, how it works, etc.

i would like free resources because i have no money. if your research is not accessible, i dont want it. i have a life and i do not have the time to go scrolling and searching for hours and hours for free, accessible papers.

do not give me your personal experiences, i want academic research thank you.

this is partially for my upcoming post with my opinions on spiritual plurality. partially for general readings.

no i am not changing my mind on the fact that pwdid deserve their own space, and endos need to stay away from that.

dont make me fucking regret this.

[granulesofsand]

If you can afford and aren’t opposed to donating to the internet archive or Wikipedia, please do that. I fear an internet where our history is not readily available in places it once was. I don’t think we’ll recover.

[chaos-in-one]

You know, I've never attempted to intentionally create an alter- or even really considered it much, because for us, a new person is typically associated with stressful and traumatic situations which isn't something I'd want to intentionally put myself through, and also brings a lot of uncertainty because there's no guarantee any new person will be stable or even someone I or others will get along with, and can easily throw off how well we are functioning.

But goddamn lately have I been thinking about it, mainly out of spite for the amount of people (or at least, amount of posts & asks, no guarantee they're all from separate people) who have been bitching about created alters & created systems existing.

[unfamiliar-ghostly-system]

On the "people with CDDs and 'endos' can never have a shared experience and are nothing alike!" conversation I just want to bring up that even people with (C)PTSD, DPDR, and a multitude of other disorders and experiences who aren't plural can have similar experiences to people with CDDs.

This isn't to say I don't support separate spaces, I do. I think we can support that without implying anything about the mental health and being of endogenics and without isolating the experiences of people with CDDS.

[autizta]

what do traumaendo systems pick in your poll-

I didn't add midway terms for a reason, stop and think which of those descriptions are CLOSEST to how you feel, doesn't have to be an exact description

[sysciety]

Open system question - how would you personally define ANP and EP? Do you stick closer to what the research/medical definition is, or does it deviate (it's ok if you don't know!) I've been reading parts of the haunted self recently (chapter 1-4 specifically) which has made me curious on what the community perception on the definitions were and how they deviate from clinical ones

[sysmedsaresexist]

Hello. I know I've sent in messages before but very very rarely. But recent events have caused us to have a question. Just this week, we got officially diagnosed with D.I.D and recommended the idea of getting a psychologist for the first time in my life, besides a psychiatrist. Two of my alts say they can't be serious but the other three think they are bout the psychologist and we are nervous. I saw you talking about disorganized attachment in your latest posts and was wondering if you could tell me more bout what that is because it sounds like I may have experienced that and I'm trying to understand myself and us more from others with experience with D.I.D and similar disorders. We hope that makes sense! We are still very new to all of this. Thank you so much for your time. - Us

First, congrats!!! Try to come back and tell us what therapy and the interviews are like! I'm certain my followers would love to hear about it. It's scary, I'm so proud of you ❤️

Disorganized attachment is both very complicated, and quite easy to understand. I just reblogged a couple old posts about it, but this will be shorter :)

This is my favorite image to describe it!

Note that disorganized attachment (DA, from here on) is linked to low trust in self AND others. All of these types of attachment have shown strong links to different types of disorders, but DA is most associated with dissociative disorders.

The most important thing I've learned is

Even well-meaning, well-intentioned, loving parents can cause DA

DA can be hidden trauma, its relation to neglect is much stronger than originally thought, and neglect is a lot harder to spot and understand than straight up abuse.

A quick note here: DO NOT play trauma Olympics-- with yourselves, with others, on this post, nothing. Trauma is a personal reaction to events, abuse, or neglect and can occur in response to literally anything. When it comes to CDDs, we're looking at cumulative responses resulting in psychopathology, and you don't get to decide what was enough for other people.

It's their reactions.

Mind your own business.

So, all that said, DA is about the child being both fearful and reliant on caregivers. They want to both flee to and flee from caregivers. When a caregiver is unpredictable, the child has a difficult time establishing a consistent view of the caregiver, and of themselves. In other words, the caregiver is both needed, and someone to be avoided, and the child may not understand what makes them a “good” or “bad” child, as the caregiver’s behavior is often confusing and unpredictable.

I'm going to throw out a couple examples here:

Parent A has yelled at you, and you're scared to go to parent B and talk about it - neither parent feels safe but they're your only source of comfort

You're hungry, but parents scold you for eating too much - you're both scared to ask for your needs and yet reliant on their abilities to meet them

Sometimes parent is attentive and kind, and sometimes very dismissive - you never know what you're going to get, but when they're dismissive, it kills your drive for things you thought you enjoyed - sometimes parent puts your art on the fridge and sometimes they throw it in the trash, and maybe that particular piece was important and you'd expected better reception

Parent gets physical when they drink but at school, parent is a model citizen and teachers and other students always tell you how lucky you are

Parents are openly homophobic and you think you might be a little gay - they're good people otherwise (you think), and maybe if you just keep that part of you down...

Parent struggles with their own mental illness and you never know what kind of reaction they'll have, but you treasure the good memories and hold out hope you'll see that side of them again, despite the many letdowns

Parent doesn't let you keep anything to yourself, it's to the point you want to avoid them as much possible, only seeing them for meals

Parent is... mean. Just flat out mean, and they'll tell you no one will listen to you. There's no point is trying to find help with other caregivers-- teachers, babysitters, friends. It's just you and them, against the world.

The start of DA is typically formed in infancy when a parent doesn't respond properly to their child. Missed feedings, not enough skin time, mixing "cry it out" with giving in, ignoring cries for food or changing. These first attachments in infancy set the tone for all your attachments going forward. Meeting needs and milestones help the brain develop in a healthy way. If some of these milestones are missed or slowed, you tend to see psychopathology of some kind as a result. Various future relationships are likely to be affected, and more often than not, you respond to your own children the same way-- a type of intergenerational trauma.

And this is only the grey areas. We haven't touched full and proper abuse and how that can affect someone.

The result of DA is that a child will try to push memories and feelings about their caregivers down so that they're not bothered-- they can interact with their caregiver, whatever mood they're in or whatever happened yesterday.

If you just kill your feelings, parent's outbursts don't hurt as much. If you just don't think about what they did to you, you can put on a smile and get through dinner.

This is, in and of itself, dissociation. A rejection of feelings or memories. DA on its own isn't very likely to cause a CDD, but with additional trauma, it's... oof.

Children with DA and suffering from abuse “are likely to generate two or more dissociated self states, with contradictory working models of attachment,” in order to handle their confusing relationship with the caregiver. This can go in several directions, not necessarily a CDD, but it becomes much more likely.

So, the child needs to maintain a relationship with the caregiver– they have no one else to turn to, so the child can develop dissociation as a way to make sense of themselves, and to maintain a child-caregiver relationship. They may “forget” the abuse, or deny it. “It is an adaptive and defensive strategy that enables the child to function within the relationship, but it often leads to the development of a fragmented sense of self.” This fragmented sense of self may or may not develop into something worse– namely, BPD and DID based on severity, frequency, and whether there was any sense of reprieve (i.e. a child can avoid the worst of dissociative symptoms if one of their parents was more supportive, because it helps them build some positive attachments).

I really hope this helps!

Good luck, come back soon!

[system-of-a-feather]

Short Term Memory + CDD; Survey Data Analysis

Hey its been a while XD I finally am getting around to computing some of the data analysis while I have time during my recovery from top surgery. With that being said, to increase the likliness of putting *anything* out, as I crunch the numbers and what not, I'll post them in updates.

With that being said, while I'd like to invest the time into doing proper statistic measures to test statistical significance, I am currently Too Lazy to do that for a small fun project. Maybe if I get bored and have time I will properly run those statistics, but for now, yall can get what you get

[the-abyssal-system]

Singlets stop talking about systems as if you’re an expert because you follow some on tumblr challenge (also warning the tags here are a huge rant so feel free to ignore that)

[granulesofsand]

🗝️🏷️ internalized fakeclaiming, RA/TBC/OA

As a self, I don’t really believe we went through extreme trauma. I know we have scars and the CAT scan showed some old damage, but I’m not convinced that absolutely ties back to memories. I’m allowed to do this because these are my memories, I’m a subsystem member who was there for that. I do the therapeutic neutrality thing to other residents, which they hate; I neither believe nor disbelieve you, I wasn’t there and you can’t prove it.

Every time I get close to deciding maybe this happened, I read another academic article telling me not to do that (or at least clinicians not to do that for their clients). I list all the reasons I’ve read mean we’re faking, even when I don’t do those things. I don’t think it’s healthy to apply those rules to others, but I can’t hold that for myself. If they say we’re one person, I don’t get to argue. If we’re one person, everything they do is my problem. We’re all faking together, even if I don’t experience myself as a part.

They go to group therapy. They’ve told people about what we’ve been through, even if not the details. I can’t do that, not even in therapy, but they’ve gone and done it already, so I guess I did too.

Our presentation people always use the same sing-songy annoying voices, and that means we’re lying about whatever they say we went through; belle indifference.

We don’t stay inside all day, we’re not properly disabled by our trauma, so how could we have gone through something that bad and not show it?

I’m not allowed to hide, I’m not allowed to flinch, I don’t feel anything about my memories but hopelessness. Towards the end I didn’t have any fear left to give. Can’t have trauma without trauma responses, and those ones don’t count. I don’t know about what the others do or how they’re ruining our lives, so probably they’re not. We’re not symptomatic enough for that to be real.

Amnesia is why I have injuries. An external cultural narrative is why I have these memories. Exo trauma, but I can’t deal with that in reality. My therapist says I can, but nobody else does. Maybe I’m a bad influence.

I know we have DID (are DID? I don’t know the phrasing), but you can get that from any kind of trauma. Some people don’t have any, their brains just do it. We have some, maybe. But not enough to justify our structure. Maybe we do have MADD and most of us aren’t real. They’re gonna be upset that I said that, though.

We talk about the system. We have social media and use our names sometimes in public. That’s weird, we’re supposed to be ashamed about it. I’m ashamed that we’re not ashamed. I don’t know enough about the others to talk about them. I think maybe I do want to, and that’s bad.

They say they want to be CDS (have CDS? A CDS?), Complex Dissociative Structure. That this is healing. I thought we’re supposed to suffer.

I remembered my name. It’s maybe not an insult. Normal DID systems have that, it’s not indicative of anything. Maybe just trauma.

If doctors don’t believe me, I must not be believable. It’s not that those things can’t happen, but they couldn’t happen to me. I had a good life, my family was mostly functional. They didn’t mean to break us, even if they didn’t care to know better.

It’s like a bruise, it’s better if it’s not real. I made it up, or our brain gave it to me as symbolism. I’m barely real. A confused part of a person who reads too much. That must be it.

I’m not supposed to complain about other residents’ coping, but we do this too often. Even if those articles are right, they are very clearly not helping. I believe our therapist — our reality matters, even if it’s only real to us. It’s not like we’re pressing charges, and they don’t own us to say we’re ruining their lives by leaving. It’s like a damn rupture with a clinician who doesn’t even treat us.

[multipleterminologysurvey]

In an effort to make this survey productive, we've been learning about social and survey research and methods, etc.

The good news is that we were already aware enough of things people need to question about research and surveys, along with considerations for ways the survey itself can influence peoples' answers, that it all is similar to the idea we already had in mine for how to approach this. It's not formal research, but it's not taking a shot in the dark and going into it without having any idea of what we're doing.

We have been learning a lot though, and it's very interesting.

[soldier--poet--queen]

crying screaming sobbing throwing up etc over livio/razlo in the manga

[sysmedsaresexist]

Casual reminder that the ToSD is supported by brain scan studies

Dissociative part-dependent biopsychosocial reactions to backward masked angry and neutral faces: An fMRI study of dissociative identity disorder.

Functional Neuroimaging in Dissociative Disorders: A Systematic Review

Dissociative Part-Dependent Resting-State Activity in Dissociative Identity Disorder: A Controlled fMRI Perfusion Study

Dissociative identity state-dependent working memory in dissociative identity disorder: a controlled functional magnetic resonance imaging study

Neurobiology and Treatment of Traumatic Dissociation

I'll probably keep adding more to the comments for my own records