do you know if the treatment for OSDD-1a seems to be the same for OSDD-1b and DID, and if not, then what is the treatment exactly? OSDD-1a does seem to have a comparatively different structure from other CDDs that would require a different structure of treatment.
I’m not quite sure what you mean by, “OSDD-1a does seem to have a comparatively different structure from other CDDs that would require a different structure of treatment.” That’s not really how OSDD1a is clinically conceptualized at all. Interestingly, the modifiers 1a and 1b are almost exclusively community terms. I’ve never met a single therapist who works with CDDs who uses those labels, and maybe only one or two who even know what they are/mean. It’s just not really a thing out in the real world.
The reason for that, as best I know it, is because unlike in most online OSDD/DID spaces, CDDs are not viewed as “alter disorders” in professional dissociative disorder spaces. They’re viewed as complex trauma disorders. They’re viewed as more complex presentations of CPTSD. Having dissociated parts is only part of the picture, and the level of elaboration or emancipation between parts doesn’t change the overall treatment guidelines. The “structure” of OSDD1a is exactly part of what would be expected for a disorder that exists along the continuum of complex dissociation.
This hopefully comes as good news to people who identify with the OSDD1a label and who may have felt increasingly more isolated within our online communities due to the (over)emphasis on having elaborated parts. We’re all really one and the same. We have fragmented senses of self. We have dissociation on the level of the personality. Just because I might have alters Bob and Joe and Jane and someone else has parts who all go by the same name doesn’t mean we’re experiencing anything that’s fundamentally different from each other. It’s all in the same family. It’s all variations on a theme.
So yeah, not only would the average CDD therapist have literally no idea what OSDD “1a” is, but if they’re sufficiently trained, then they’re all gonna approach treatment through the same ISSTD evidence based treatment guidelines and then tailor and personalize that approach to match the specific symptoms and needs of that individual client. Of course treatment looks slightly different for everyone depending on the therapist, their preferred modalities, and the client. But the foundation is the same. The goal to lower dissociative barriers and bring parts together to improve function and stability is the same. Etc.
I think tumblr and other CDD online spaces could strongly benefit from a push to de-emphasize CDDs as disorders that cause primarily elaborated, distinct, clearly defined alters. My team has worked with several CDD clients over the past year, and guess what—only ONE of them had clearly defined parts. ONE. It’s really not as common out here irl. It’s a far more common presentation to encounter clients with pervasive trauma-related complex dissociative symptoms who don’t meet DID criteria because they don’t have elaborated parts. Or who only have a couple decently defined parts, which is enough to meet DID criteria, but mostly it’s a murky dissociative mess of parts. It’s what I’m more familiar with as a professional tbh. You don’t need well defined parts to have a CDD. There’s so much more to it. And I hate how this emphasis on alters has made other people with CDDs feel so lonely when dude…they’re the majority. They just don’t get much of a voice or they feel like they don’t fit in.
My last rant (sorry, you probably weren’t looking for all this) is that many polyfragmented DID systems, myself included, often appear more OSDD1a because of how many fragments and poorly elaborated, highly specialized parts we tend to have. I have waaaaaay more “OSDD1a style parts” than I do fully elaborated DID stereotypical parts and sometimes that’s kinda isolating for me too. I resonate a lot with OSDD1a spaces. Which just goes to show that it really is all on the same spectrum. There are infinite combinations of structures and presentations that make up CDD systems. But treatment wise, it’s pretty much the same! Aside from any modifications that might be utilized by a therapist to match the individual client! But being person-centered in treatment doesn’t mean they’re gonna throw out the ISSTD treatment guidelines or anything.
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