A More Nuanced Discussing on Structural Dissociation and Alternatives
The structural dissociation model originated from the book The Haunted Self in 2005. (Though the authors began using the term a bit before that in the early 2000s, it's The Haunted Self that formalized what structural dissociation is.)
This model was built on some older theories for how dissociation worked but it is also distinct from those earlier theories. The structural dissociation model incorporates many of Janet's theories from a hundred years before as well as those of WWI psychologist Charles Samuel Myers.
Something that I really need to clarify right from the start is that the structural dissociation model is NOT the trauma model. It's a trauma model. One of many that have existed. The "trauma model" should be seen as an umbrella which the structural dissociation model falls under.
I want to state this here because disputing the structural dissociation model is not disputing DID being primarily traumagenic.
What causes structural dissociation?
Here is the very short version:
When someone experiences trauma, they cannot integrate the traumatic experience into their sense of self. This causes it to form an "Emotional Part" or EP which holds the traumatic experience. In basic PTSD, this part is not elaborated or significantly emancipated. (Meaning that it's not very separate.)
The part that operates the body during daily life is called an "Apparently Normal Part" or ANP. (These terms are borrowed from what Myers observed in PTSD in WWI soldiers but weren't applied to DID until the structural dissociation model.)
Children naturally have a less integrated personality since the personality solidifies later in life. For this reason, DID only arises from childhood trauma. Later life trauma cannot cause dissociative identity disorder but will result in other forms of structural dissociation.
Alters are essentially the trauma parts caused by PTSD that have become more elaborate and separated with time.
That's the basics for how structural dissociation forms under this model. On its surface, it's certainly not bad by any means.
But it's also not the only trauma model.
The Imaginary Companion Model
As an example of an alternative, at one point, many believed the pathway for the formation of alters started with them as "imaginary companions."
In The evolution of alter personality states in dissociative identity disorder (DOI: 10.1037/h0087838), it's proposed that alters originate from ICs. When the child experiences trauma, they would dissociate from that trauma and instead attribute it to the imagined companion.
I am not pointing to this model to say "this is true and the structural dissociation model isn't."
I am just using this to illustrate an alternative trauma model. And to be clear, this IS a trauma model. Despite the involvement of fantasizing in this proposal, it's not a fantasy model. The fantasy model is one that proposes memories of trauma are created through fantasy, and never actually happened. (Also, "fantasy" in a psychological context simply means imagining. It does not necessarily mean that it's something that was wanted.)
Structural Dissociation Model vs Imaginary Companion Model of Development
Here's the basic pathway for each for comparison.
Structural Dissociation Model: A child suffers trauma and creates an EP -> The child continues to suffer trauma causing the EP to be activated more often -> Over time, this EP becomes elaborated and develops into a full alter.
Imaginary Companion Model: A child creates an imaginary companion and defers aspects of the trauma onto the imaginary companion -> The imaginary companion begins taking over to deal with stressful situations -> The imaginary companion becomes a full alter.
The differences between the two models are actually pretty subtle. But the biggest difference is that an imaginary companion is going to start out with a greater degree of elaboration, likely with their own names, genders and histories, while the EP under structural dissociation would develop those things later in life.
Which developmental model is true?
Honestly, maybe both. đ€·ââïž
I've listened to enough DID systems who have described experiences that could work for both models. Perhaps both have truth to them. In which case, neither is wrong. They're both just incomplete.
Some DID systems may develop according to the structural dissociation model. Some may develop according to the imaginary companion model. And some may develop due to a combination of both, with different alters developing from different mechanisms.
The DSM-5 discusses how alters in childhood can present as either independent imaginary companions or personified "mood states."
Perhaps the personified mood states are cases that followed the structural dissociation path, and the imaginary companions are generally ones that follow the other path.
The problem is that any claims for what causes early development of alters are extremely hard if not impossible to truly test.
What are the Implications of Structural Dissociation on Non-Disordered Systems?
Whatever your opinion on it, the structural dissociation model pertains only to dissociation caused by trauma and is useless outside of that very specific context. The creators of the model have acknowledged that it's possible for self-conscious dissociated parts of the personality to develop without trauma.
The intention of the structural dissociation model isn't to somehow claim that no other type of plurality exists. Any attempt at using the model this way is taking it wildly out of the context it was written in.
The structural dissociation model is not against the existence of endogenic systems.
Primary, Secondary and Tertiary Dissociation... What Are They and Are They Useful?
These are the three levels of dissociation presented in the Haunted Self.
These levels of dissociation are where you really start to see the holes in the model.
A lot of the claims that are being made here are unproven, and difficult to test.
Basic PTSD is placed in the primary dissociation category because it only has one emotional part. But can this be proven? If parts aren't elaborated then are we able to really show that only one part is present?
What if a soldier in a war has PTSD from different traumas? Would they have the same emotional part for being forced to kill an enemy combatant that they would for being sexually assaulted by people that they serve with? I would think probably not.
These are two separate traumas that would most likely invoke different trauma responses. So if they had multiple emotional parts due to multiple traumas, would this be primary or secondary dissociation?
And since the creators of the model have acknowledged that there may be self-conscious dissociative parts formed from other means, what happens if somebody who already had secondary dissociation intentionally used one of these practices to create a headmate? Then that headmate starts regularly fronting and sharing responsibilities in the daily life? By the definitions given, this would now rise to the level of tertiary dissociation. But the dissociation became more complex for reasons other than trauma. (Although trauma was already present before.) And a trauma disorder becoming more complex for non-trauma reasons feels wrong.
I could go on and on because there are so many issues with how this model presents these levels of dissociation.
Some headmates don't hold trauma but don't front like ANPs, making them neither ANPs nor EPs. Some ANPs also hold trauma making them both ANP and EP. Some headmates can evolve from EPs into ANPs.
On the other hand, the vast complexity of dissociation is something the authors acknowledged.
Before the text that I quoted, the authors actually say that these levels are only meant to be a prototype. They acknowledge that it's not perfect and expect people to build onto it.
So the biggest problem with the levels of dissociation might not be from the authors themselves. Rather, it would be from people who treat the levels of dissociation as gospel when this is not how they were originally intended to be treated. They were always a prototype that the authors knew were incomplete when they wrote the book.
So, are these levels Still Useful as a Prototype?
Personally, I'm still going to say that I don't really like them. I don't think that the levels of dissociation are really something that are workable. I don't think that you can judge how severe dissociation is based purely on the number of ANPs and EPs present in a system.
I dislike the levels of dissociation as a concept. The problem with prototypes is that sometimes you find that you just can't build them into anything that's actually useful in practice. This might be controversial, but I think that this is one of those cases.
I don't think that looking at the numbers of EPs and ANPs is something that would help clinicians know how to treat somebody's disorder.
Even if you put in the work to account for the cases that I mentioned earlier, I think that you would be overcomplicating things to force the levels of dissociation work instead of accepting that they are a flawed concept at their very core, whitling away at a round peg to try to fit it into a square hole.
Wrap-up: What do I like about the Structural Dissociation Model? What do I not like?
I think the basic premise, that many DID alters originate from the same traumatized parts that are typical in PTSD cases, is actually a pretty novel approach that ties a lot of these disorders together. This is the part of the theory I do like, even if I don't think it's applicable in every case.
I do think many of the claims are hard to prove though. To the point that people have provided evidence that this is the correct model, a lot of that evidence could apply to any variation of the trauma model. A brain scan can show a difference between an alter with trauma and one without, but it can't prove if the trauma holder began from a PTSD EP or if it began as an already-existing imagined companion who the trauma was later deferred to.
Additionally, as I said, I strongly dislike the levels of dissociation and don't find them useful.
Should the Imaginary Companion Model be Revisited?
As far as I can tell, interest in the imaginary companion model fizzled out after the structural dissociation model was established.
I strongly suspect part of the reason for this is the politics of the "memory wars." During the 90s, there was a strong backlash against the trauma model, driven by a group called the False Memory Syndrome Foundation which claimed that memories of abuse were all fake and formed by an unproven syndrome they invented, called false memory syndrome.
The structural dissociation model was developed right after this backlash in the early 2000s. It's hard to think that the rush to adopt it wasn't driven at least in part by a desire to cut any ties with theories that involved fantasy at all, even if those theories were still trauma-based models.
Perhaps in a world where the "memory wars" never happened, the imaginary companion model would be more prominent. The hard swing towards structural dissociation as the only explanation, I think, should be seen less as an example of following the science and more as a direct reaction to the politics of the memory wars.
And I think it's a shame that these links have been severed because some cool things have happened in the realm of psychological research into imaginary companions in the years since. In the early 2000s, around the same time that the structural dissociation model was being created, imaginary companions started getting more attention.
We've now seen numerous studies demonstrating autonomy in about a third to two thirds of imaginary companions. Studies into tulpas, which are seen as being created though similar mechanisms to these complex ICs, started in the last decade.
It's possible that many ICs in children may already have a degree of elaboration and emancipation without trauma being present at all. If so, this could completely turn the projected development of DID on its head completely in these cases. Instead of an alter beginning from a traumatizing experience and becoming elaborated and emancipated later, it could already be elaborated and emancipated and later adopt the traumatizing memories.
To be clear, I am am not suggesting this as an opposing or competing model to the development course seen under the structural dissociation, but a complimentary one. An addition to it that explains some experiences of DID systems that the structural dissociation model doesn't, to help build a more complete model of dissociation.
